NSAIDs and blood pressure

NSAIDs elevate blood pressure averagely 5 mmHg.

A systematic review including 38 randomised, placebo-controlled trials, and 12 randomised but not placebo-controlled studies was abstracted in DARE.

NSAIDs elevated supine mean blood pressure by 5.0 mmHg (95% CI 1.2 to 8.7 mmHg), NSAIDs had no significant effect on weight, creatinine clearance, plasma renin activity or daily urinary excretion of sodium and prostaglandins. NSAIDs antagonised the antihypertensive effect of beta-blockers (blood pressure elevation, 6.2 mmmHg, 95% CI 1.1 to 11.4 mmHg) more than they did that of vasodilators and diuretics. Among NSAIDs piroxicam produced the most marked elevation in blood pressure (6.2 mmHg, 95% CI 0.8 to 11.5). Sulindac and aspirin had the least hypertensive effect.

Comment: A high-quality meta-analysis.

The following decision support rules contain links to this evidence summary:

• NSAIDs as the cause of elevated blood pressure

Ədəbiyyat

1. Johnson AG, Nguyen TV, Day RO. Do nonsteroidal anti-inflammatory drugs affect blood pressure? A meta-analysis. Ann Intern Med 1994 Aug 15;121(4):289-300.