title: [Clinical relevance of drug interactions between nonsteroidal antiinflammatory drugs (NSAIDs) and antihypertensives].
abstract: OBJECTIVE
  To establish the clinical relevance of drug interactions between nonsteroidal antiinflammatory drugs (NSAIDs) and antihypertensives, based on the interaction severity and probability of occurrence.
  
  
  METHODS
  Systematic review.
  
  
  METHODS
  A PubMed/Medline search was made using the MeSH terms: NSAIDs, Antihypertensive drugs, and Drug interactions.
  
  
  METHODS
  Articles between 2002 and 2012, human studies, in Spanish and English and full text access were included. Found articles were included and some of the references used in this works. Studies with in vitro methods, effects on ocular hypertension and those who do not consider the interaction NSAIDs, antihypertensives were excluded. For the selection of the papers included three independent reviewers were involved. We used a tool for data extraction and for assess of the interaction clinical relevance.
  
  
  RESULTS
  Nineteen of 50 papers found were included. There were identified 21 interactions with pharmacodynamic mechanism, classified by their clinical relevance in level-2 high risk (76.2%) and level-3 medium risk (23.8%). In addition, evidence of 16 combinations of no interaction were found.
  
  
  CONCLUSIONS
  Some NSAIDs may attenuate the effectiveness of antihypertensive drugs when used concurrently, especially with angiotensin converting enzyme inhibitors, diuretics, beta blockers and angiotensin receptorsii blockers. There was no evidence of effect modification of calcium channel antagonists, especially dihydropyridine, by concurrent use of NSAIDs.
authors.affiliation: Grupo de Investigación, Promoción y Prevención Farmacéutica, Facultad de Química Farmacéutica, Universidad de Antioquia, Medellín, Antioquia, Colombia. Electronic address: jvillao@farmacia.udea.edu.co.
authors.forename: Juan
authors.initials: J
authors.lastname: Villa
authors.affiliation: Grupo de Investigación, Promoción y Prevención Farmacéutica, Facultad de Química Farmacéutica, Universidad de Antioquia, Medellín, Antioquia, Colombia.
authors.forename: Alejandra
authors.initials: A
authors.lastname: Cano
authors.affiliation: Grupo de Investigación, Promoción y Prevención Farmacéutica, Facultad de Química Farmacéutica, Universidad de Antioquia, Medellín, Antioquia, Colombia; Programa de Atención Farmacéutica HUMAX, Itagüi, Antioquia, Colombia.
authors.forename: David
authors.initials: D
authors.lastname: Franco
authors.affiliation: Grupo de Investigación, Promoción y Prevención Farmacéutica, Facultad de Química Farmacéutica, Universidad de Antioquia, Medellín, Antioquia, Colombia; Programa de Atención Farmacéutica HUMAX, Itagüi, Antioquia, Colombia.
authors.forename: Mauricio
authors.initials: M
authors.lastname: Monsalve
authors.affiliation: Grupo de Investigación, Promoción y Prevención Farmacéutica, Facultad de Química Farmacéutica, Universidad de Antioquia, Medellín, Antioquia, Colombia; Programa de Atención Farmacéutica HUMAX, Itagüi, Antioquia, Colombia.
authors.forename: Jaime
authors.initials: J
authors.lastname: Hincapié
authors.affiliation: Grupo de Investigación, Promoción y Prevención Farmacéutica, Facultad de Química Farmacéutica, Universidad de Antioquia, Medellín, Antioquia, Colombia; Universidad de Antioquia, UdeA, Medellín, Antioquia, Colombia.
authors.forename: Pedro
authors.initials: P
authors.lastname: Amariles
mesh_terms: D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000494:pharmacology*; D000959:Antihypertensive Agents / Q000494:pharmacology*; D004347:Drug Interactions; D006801:Humans
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D000959:Antihypertensive Agents
keywords: Anti-inflammatory non-steroidal agents; Antihipertensivos; Antihypertensive agents; Antiinflamatorios no esteroideos; Blood pressure; Clinical relevance; Drug interaction; Interacciones medicamentosas; Presión arterial; Relevancia clínica