A Nurses Health Study at Harvard Medical School and Brigham and Women’s Hospital in Boston has found that women who take high daily doses of over-the-counter (OTC) pain relievers including ibuprofen (Advil and Motrin), naproxen (Aleve), and acetaminophen (Tylenol) are at greater risk for developing high blood pressure or hypertension.
Results of the study were published online Monday in the American Heart Association journal Hypertension.
Ibuprofen and naproxen are classified as non-steroidal anti-inflammatory drugs or NSAID and have previously been linked to high blood pressure. The federal government has just been required to carry stricter warning labels on NSAIDs because of an elevated risk of heart-related problems. Acetaminophen, however, had been largely considered risk free.
It is also significant to note that many arthritis pain sufferers turned to these alternative OTC painkillers in desperation when it was disclosed that the widely prescribed class of drugs known as COX-2 inhibitors (Vioxx, Bextra, Celebrex) posed an increased of heart attack.
Although Harvard researchers have found a connection between high blood pressure and painkillers in the past, the recent study was the first to rule out the possibility that patients taking the painkillers under consideration were already suffering from hypertension.
The study, considered 5,123 women participating in the Nurses Health Study at Harvard Medical School and Brigham and Women’s Hospital in Boston. The women, who were between 34 and 77 did not have high blood pressure at the beginning of the study and were monitored for up to eight years.
Results showed that women 51 to 77 who took an average of 400 milligrams of ibuprofen a day were 80% more likely to develop high blood pressure than older women who did not take the drug.
Women in the same age group who took an average daily dose of more than 500 milligrams of acetaminophen (one extra-strength Tylenol) almost doubled their risk of developing high blood pressure within about three years.
Those who took more than 400 milligrams of ibuprofen daily (about two Advil) had a 78% grater risk of developing high blood pressure.
Younger women (aged 34 to 53) who took those daily doses of 400 milligrams of ibuprofen or NSAIDs were 60% more likely to develop high blood pressure and those who took an average of more than 500 milligrams acetaminophen a day had a two-fold higher risk of developing high blood pressure.
The risk of developing high blood pressure, for women who did not take OTC painkillers is approximately 1% to 3% a year.
Dr. John Phillip Forman, of the Harvard Medical School and an associate physician at Brigham and Women’s Hospital in Boston, said the findings did not indicate that women should stop taking pain medication. “We are by no means suggesting that women with chronic pain conditions not receive treatment for their pain. By pointing out risks associated with these drugs, more informed choices can be made by women and their clinicians.”
Currently aspirin remains the safest pain reliever for women. In the study it was not shown to effect blood pressure. This is probably because aspirin has a different effect on blood vessels in comparison with ibuprofen, which may increase sodium and effect levels of nitric oxide triggering blood pressure changes.
Future studies will consider what relationship, if any, OTC pain medications have on increased hypertension in men.