Comparison of changes in blood pressure measurements and antihypertensive therapy in older, hypertensive, ambulatory care patients prescribed celecoxib or rofecoxib.
OBJECTIVE
To determine if changes in blood pressure and changes in class or dosing of antihypertensive drugs were significantly different in patients treated with celecoxib versus rofecoxib, two cyclooxygenase (COX)-2 inhibitors.


METHODS
Retrospective cohort study.


METHODS
Thirty-one ambulatory care practices that shared an electronic medical record.


METHODS
Nine hundred sixty men and women over age 55 years with stable hypertension.


METHODS
Patients had to have at least a 30-day supply of celecoxib or rofecoxib (any dose) prescribed between July 1, 1999, and June 30, 2000.


RESULTS
Patients were followed for 6 months, and logistic regression and survival models were used to compare outcomes between groups while adjusting for confounders. Baseline characteristics of 517 patients receiving celecoxib and 443 receiving rofecoxib were similar. No significant differences were observed, regardless of the COX-2 inhibitor prescribed, in the proportion of patients whose systolic blood pressure increased by 20 mm Hg, whose diastolic blood pressure increased by 15 mm Hg, or who were prescribed a new class of antihypertensive drug. Compared with patients taking celecoxib, those taking rofecoxib were significantly more likely (odds ratio 1.68, 95% confidence interval 1.09-2.60) to have had the dosage of their antihypertensive drug increased and also the dosage increased sooner (p<0.05). New-onset cardiac and renal comorbidity, number of physician visits, and changes in body weight and laboratory values were not significantly different between the groups.


CONCLUSIONS
No significant differences in blood pressure changes or in the proportion of patients who were prescribed a new class of antihypertensive drug were found between rofecoxib- and celecoxib-treated patients. However, significantly more rofecoxib-treated patients had the dosage of their existing antihypertensive drug increased compared with those receiving celecoxib.
Nietert
Paul J
PJ
Center for Health Care Research, Department of Medicine, Medical University of South Carolina, Charleston 29425, USA. nieterpj@musc.edu
Ornstein
Steven M
SM
Dickerson
Lori M
LM
Rothenberg
Ralph J
RJ
D000368:Aged; D000369:Aged, 80 and over; D000553:Ambulatory Care / Q000379:methods / Q000706:statistics & numerical data*; D000959:Antihypertensive Agents / Q000494:pharmacology / Q000627:therapeutic use; D001794:Blood Pressure / Q000187:drug effects* / Q000502:physiology; D000068579:Celecoxib; D016009:Chi-Square Distribution; D015331:Cohort Studies; D005260:Female; D006801:Humans; D006973:Hypertension / Q000188:drug therapy* / Q000503:physiopathology; D007783:Lactones / Q000494:pharmacology / Q000627:therapeutic use*; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016016:Proportional Hazards Models; D011720:Pyrazoles; D012189:Retrospective Studies; D013449:Sulfonamides / Q000494:pharmacology / Q000627:therapeutic use*; D013450:Sulfones
D000959:Antihypertensive Agents; D007783:Lactones; D011720:Pyrazoles; D013449:Sulfonamides; D013450:Sulfones; C116926:rofecoxib; D000068579:Celecoxib