title: Antihypertensive effect of the combination of fosinopril and HCTZ is resistant to interference by nonsteroidal antiinflammatory drugs.
abstract: Nonsteroidal antiinflammatory drugs (NSAID) are frequently reported to interfere with the blood pressure lowering actions of various antihypertensive medications. We studied 17 women with arthritis and hypertension who were receiving fosinopril and HCTZ, and administered sequentially in random order ibuprofen, sulindac, and nabumetone for 1 month each, with an intervening 2-week washout period between each treatment period. During the washout period, subjects received acetaminophen. Blood pressure at the end of 2 weeks of acetaminophen was compared with blood pressure after 1 month of treatment with each of the NSAID. Mean blood pressure was unchanged before and after all NSAID: 108 +/- 7 v 107 +/- 9 for nabumetone, 108 +/-9 v 108 +/- 9 for sulindac, and 108 +/- 8 v 107 +/- 9 for ibuprofen. The 24-h urinary sodium excretion was not significantly different. We conclude that the three NSAID did not neutralize the antihypertensive effect of the combination of fosinopril and HCTZ, and hence the blood pressure lowering action of the combination may not be prostaglandin dependent.
authors.affiliation: Department of Medicine, Louisiana State University Medical Center, New Orleans 70112, USA.
authors.forename: V
authors.initials: V
authors.lastname: Thakur
authors.forename: M E
authors.initials: ME
authors.lastname: Cook
authors.forename: J D
authors.initials: JD
authors.lastname: Wallin
mesh_terms: D000082:Acetaminophen / Q000627:therapeutic use; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use*; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use*; D001168:Arthritis / Q000097:blood / Q000188:drug therapy* / Q000652:urine; D001794:Blood Pressure / Q000187:drug effects; D002074:Butanones / Q000627:therapeutic use; D003404:Creatinine / Q000652:urine; D015232:Dinoprostone / Q000097:blood; D004232:Diuretics; D004347:Drug Interactions; D004359:Drug Therapy, Combination; D005260:Female; D017328:Fosinopril / Q000627:therapeutic use*; D005919:Glomerular Filtration Rate / Q000187:drug effects; D006801:Humans; D006852:Hydrochlorothiazide / Q000627:therapeutic use*; D006973:Hypertension / Q000188:drug therapy* / Q000378:metabolism / Q000503:physiopathology; D007052:Ibuprofen / Q000627:therapeutic use; D008875:Middle Aged; D000077430:Nabumetone; D017595:Renal Plasma Flow / Q000187:drug effects; D012964:Sodium / Q000652:urine; D049993:Sodium Chloride Symporter Inhibitors / Q000627:therapeutic use*; D013467:Sulindac / Q000627:therapeutic use; D013929:Thromboxane B2 / Q000097:blood
chemical_list: D000806:Angiotensin-Converting Enzyme Inhibitors; D000894:Anti-Inflammatory Agents, Non-Steroidal; D002074:Butanones; D004232:Diuretics; D049993:Sodium Chloride Symporter Inhibitors; D006852:Hydrochlorothiazide; D013467:Sulindac; D000082:Acetaminophen; D013929:Thromboxane B2; D012964:Sodium; D003404:Creatinine; D015232:Dinoprostone; D000077430:Nabumetone; D017328:Fosinopril; D007052:Ibuprofen