[Effects of NSAID on blood pressure among hypertensive patients with a high cardiovascular risk].
BACKGROUND
An elevation in the risk of cardiovascular (CV) events and blood pressure (BP) levels in patients treated with COX-2 inhibitors compared to non selective NSAID has been shown previously.


OBJECTIVE
To compare the effects of NSAID (COX-2 inhibitors and non-selective) on BP levels and control of HT. To determine the association between NSAID use and coronary heart disease in HT patients with elevated CV risk.


METHODS
Cross sectional epidemiological study in 8126 ambulatory HT patients, older than 40, with a high CV risk. We obtained data on personal variables, CV risk factors, previous CV history, CV medication, analgesic and anti inflammatory drugs (AID). Control of HT was classified: optimal, suboptimal and no control. Absolute CV risk was calculated according to the WHO-ISH score.


RESULTS
44.2% of subjects took ASA and 3.7% another NSAID. SBP was 5.90 mmHg (95%CI: 2.53-9.27 mmHg) higher (p < 0.05) in patients treated with NSAID than in those with no AID medication. Patients having ASA, both SBP and DBP were 5.89 mmHg (p < 0.01) and 2.25 mm Hg (p < 0.05) respectively, lower than in patients with NSAID. However, mean SBP was similar in the ibuprofen group compared to without AID; 11.12 mmHg lower (95%CI: 3.66-18.58) than in the group on NSAID (p < 0.05) and 8.82 mmHg (95%CI: 0.27-17.38) (p < 0.05) lower than in those on COX-2 inhibitors.


CONCLUSIONS
Among HT patients, NSAID therapy (selective or not) is associated with a higher level of SBP than in those without such medication. However, patients treated exclusively with Ibuprofen show similar levels of SBP than without NSAID treatment. Frequency of ischemic disease was significantly higher in the group treated with COX-2 inhibitors than in the non-selective NSAID treated group or in patients without NSAID treatment.
González-Juanatey
J R
JR
Servicio de Cardiologia, Hospital Clinico Universitario, 15701 Santiago de Compostela, A Coruña.
Rivera
J
J
Gabriel Sánchez
R
R
Reviriego Almohalla
B
B
Casimiro
C
C
D000368:Aged; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000009:adverse effects / Q000627:therapeutic use*; D001794:Blood Pressure / Q000187:drug effects*; D002318:Cardiovascular Diseases / Q000453:epidemiology* / Q000517:prevention & control; D003430:Cross-Sectional Studies; D052246:Cyclooxygenase 2 Inhibitors / Q000009:adverse effects / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D006973:Hypertension / Q000517:prevention & control*; D008297:Male; D008875:Middle Aged; D012307:Risk Factors
D000894:Anti-Inflammatory Agents, Non-Steroidal; D052246:Cyclooxygenase 2 Inhibitors