Defining the problem of treating the patient with hypertension and arthritis pain.
As osteoarthritis and hypertension coexist often in patients aged >60 years, the coadministration of nonsteroidal anti-inflammatory drugs (NSAIDs) with hypertension therapies is common practice in clinical medicine. Clinical trials in patients with arthritis have shown that many agents within the NSAID class may induce significant increases in systolic blood pressure, particularly when patients are using renin-angiotensin-blocking agents, beta-blockers, or diuretics as antihypertensives. The increases in blood pressure caused by NSAIDs are large enough to be of clinical concern. Sustained blood pressure elevations in the elderly are associated with increases in the risk of both ischemic and hemorrhagic stroke, congestive heart failure, and ischemic cardiac events. Recognition of the development of destabilization of blood pressure control in clinical practice and an awareness of those NSAIDs that place patients at risk for the development of hypertension could lead to reductions in cardiovascular morbidity.
White
William B
WB
Division of Hypertension and Clinical Pharmacology, Pat and Jim Calhoun Cardiology Center, University of Connecticut School of Medicine, Farmington, Connecticut 06030-3940, USA. wwhite@nso1.uchc.edu
D000368:Aged; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use*; D000959:Antihypertensive Agents / Q000627:therapeutic use*; D004347:Drug Interactions; D006801:Humans; D006973:Hypertension / Q000150:complications* / Q000188:drug therapy*; D008875:Middle Aged; D010003:Osteoarthritis / Q000150:complications* / Q000188:drug therapy*
D000894:Anti-Inflammatory Agents, Non-Steroidal; D000959:Antihypertensive Agents