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Do Pain Relievers Raise Blood Pressure?

New Study Shows No Increase in Men; Experts Question Findings
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WebMD Health News

Sept. 13, 2005 -- Frequent use of over-the-counter pain relievers has been linked to high blood pressure in women. But new research fails to show the same association in men.

Findings show that men who regularly took the pain relievers were no more likely than those who didn't to have persistent high blood pressure, also known as hypertension.

So do men and women really have different risks? Probably not, says cardiologist and study researcher Michael Gaziano, MD, of Boston's Brigham and Women's Hospital and the VA Boston Health System.

Instead, the conflicting findings suggest that more study is needed to pin down the heart risks associated with long-term use of over-the-counter pain relievers.

"I don't think anybody should be worried about using these drugs for short periods," he tells WebMD.

Long-Term Risks Unknown

High blood pressure is a leading cause of stroke, heart attacks, heart failure, and kidney disease. Being overweight is the major risk factor for hypertension. Other recognized risks include smoking and getting little exercise.

Popular over-the-counter pain relievers include aspirin, ibuprofen (Advil, Motrin, and Nuprin) and naproxen (Aleve).

It is clear that many of these painkillers can raise blood pressure while they are in the system, but Gaziano says that does not present a health risk for most people.

"Many things raise your blood pressure in the short term, including walking up the stairs," he says.

But many people take the pain relievers every day for chronic conditions like arthritis. And the heart risks associated with their frequent, long-term use are not well understood.

Side Effects of Pain Relievers

The widely publicized troubles of the prescription pain reliever Vioxx led to warnings being placed on all prescription anti-inflammatory pain relievers about the potential risks of heart disease and stroke.

Expanded information was also provided on anti-inflammatory over-the-counter drugs. While short-term, low-dose use has not been linked to heart attack and stroke, stronger reminders are now included on the label about limiting the dose and duration of treatment.

It's recommended that patients not use over-the-counter anti-inflammatory drugs for more than 10 days without seeing their doctor.

Acetaminophen (Tylenol) is not an anti-inflammatory drug and has not been linked to heart disease and stroke. However, acetaminophen, like the anti-inflammatory drugs, has been linked to high blood pressure, according to the researchers.

Ask Your Doctor

The newly reported trial included just over 8,200 men followed for more than two decades. The men were participants in a larger, ongoing health study.

The participants were asked to recall the frequency of their pain-reliever use over a six-year period. None had high blood pressure at the beginning of the observation period, but about a quarter had it six years later.

After controlling for high blood pressure risk factors such as being overweight, smoking, and sedentary lifestyle, researchers found no obvious association between the frequency of pain- reliever use and hypertension.

The findings are published in the Sept. 12 issue of The Archives of Internal Medicine.

Baltimore cardiologist David A. Meyerson, MD, tells WebMD that the findings are interesting but far from definitive because the participants may have underreported or even overreported their use of pain relievers.

Meyerson practices at the Johns Hopkins Bayview Medical Center and is a national spokesman for the American Heart Association.

"I would hate for people who have heart or blood vessel disease or even hypertension to take from this study that they can use these drugs with impunity," he says. "They need to discuss with their doctor whether taking these medications is safe and reasonable for them."

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