Painkillers may up blood pressure in men

By CHRISTINE DELL'AMORE, UPI Consumer Health Correspondent

WASHINGTON (UPI) -- Men who take the three most commonly used drugs in the United States -- acetaminophen, ibuprofen and aspirin -- may have a higher risk of developing high blood pressure, a new study says.

In a group of 16,031 older men, those who took 15 or more painkillers each week had a 48-percent higher risk of developing high blood pressure, the study found.

The men, who averaged 65 years of age, did not have a history of high blood pressure, a common risk factor for heart disease. In 2000 and 2002 study participants reported to researchers how often they took acetaminophen, aspirin and other non-steroidal anti-inflammatory drugs, such as ibuprofen and naproxen.

After four years, 1,968 men were diagnosed with high blood pressure. Those men who took acetaminophen six or seven days a week had a 34-percent higher risk of high blood pressure than those who did not take the drugs; those who took non-steroidal anti-inflammatory drugs had a 38-percent higher risk, and those who took aspirin six or seven days a week had a 26-percent higher risk. The authors corrected for risk factors of high blood pressure, such as age, body mass index, alcohol use and exercise frequency.

The study, published Monday in the Archives of Internal Medicine, a journal of the American Medication Association, further examines a link between painkillers and high blood pressure found in previous studies, says study author Dr. Gary Curhan, a nephrologist and researcher at Brigham and Women's Hospital in Boston.

Two previous studies in women, also led by Brigham and Women's, found taking painkillers as little as once or twice a week could raise blood pressure. A link between acetaminophen intake and high blood pressure was particularly strong in younger women, those studies found.

Painkillers may raise blood pressure by impairing cell function and reducing the condition of the blood-vessel lining. The medications may also make the body maintain salt, which can raise blood pressure.

However, the study is not a true experiment, and the results cannot be considered conclusive. Furthermore, the researchers were not able to determine the exact timing and dosage of medication from the study participants. It's also unknown who is at the highest risk, since not everyone who takes painkillers regularly develops high blood pressure.

The study's epidemiological design could also not determine whether underlying diseases caused high blood pressure in those 1,968 patients, McNeil Consumer Healthcare, maker of Tylenol, said in a statement. Tylenol contains acetaminophen.

McNeil's statement also emphasized the study's reliance on patient-reported data, which many consider not as reliable as other methods of data collection.

Yet many say the findings will reverberate throughout the medical community. For instance, the American Heart Association issued a scientific statement Monday in the journal Circulation advising doctors to avoid prescribing non-steroidal anti-inflammatory drugs -- with the exception of aspirin -- as frontline treatments for chronic pain.

The decision is based on cumulative evidence from 121 studies and a total of 30,000 patients showing such medications can worsen the risk for heart disease, lead author Dr. Elliott Antman, a professor of medicine at Harvard Medical School and Brigham and Women's Hospital, told United Press International.

For instance, COX-2 inhibitors, a type of non-steroidal anti-inflammatory drug, have been shown to raise heart-attack risk by 86 percent as compared to placebo.

Instead of first going the pharmaceutical route, Antman said, doctors should suggest other methods, such as physical therapy, to remedy their patient's problem. A doctor should prescribe on a non-steroidal anti-inflammatory medication only as a last resort, he said.

Many doctors support finding ways to manage pain beyond popping pills.

"The first step shouldn't be medication," said Suzanne Steinbaum, director of Women and Heart Disease at Lenox Hill Hospital's Cardiology, Heart and Vascular Institute in New York. "We need to address the issues -- whether it through diet, weight loss, exercise or physical therapy -- rather than (a) pill."

Despite the common perception of aspirin and other painkillers as harmless, every medication has a side effect, Steinbaum said.

"As a culture we don't deal with pain, we just cover up the symptoms," she said, "and this is going to force us to appreciate what we put in our mouths."

What's more, many Americans take painkillers for no clear reason, or have not explored other ways to combat their pain, Curhan said. For instance, people often take painkillers for headaches without investigating possible triggers for their pain.

Next, Curhan plans to study whether painkiller-induced high blood pressure can be reversed. While research is still under way, Curhan doubts blood pressure will go down in these patients. For one thing, the longer a person has high blood pressure, the harder it is to modify.

"That's why we need to focus on prevention, rather than treatment," he said.