title: Non-steroidal anti-inflammatory drugs and blood pressure control in patients treated for hypertension: results from the Swedish primary care cardiovascular database.
abstract: OBJECTIVE
  The aim of this observational cohort study was to investigate blood pressure level and the possibility to reach target blood pressure during concomitant use of NSAID in hypertensive patients.
  
  
  METHODS
  From the Swedish primary care cardiovascular database (SPCCD) a cohort of 5463 patients (2007 to 2008) with at least one prescription of NSAID dispensed 6 months prior to the last blood pressure measurement were included. Clinical data were extracted from computerized medical records and linked to the Prescribed Drug Register. Multivariable logistic regression models were used for analysis.
  
  
  RESULTS
  Patients with NSAID usage were younger, more often female, with lower creatinine concentrations, more musculoskeletal diagnosis and less cardiovascular comorbidity compared to patients without dispensed NSAID (p < .0001 for all). Regular dose of NSAID was not associated with a decreased possibility to reach target blood pressure. A correlation between the dose of naproxen and an increase in SBP of 7 mm Hg was found. Impairment in renal function did not influence the association between blood pressure control and NSAID (p = .27).
  
  
  CONCLUSIONS
  In hypertensive patients with concomitant use of NSAID the chance to reach target blood pressure was not impaired. In intermediate and frequent users of NSAID there was a dose response relation with naproxen and SBP which was not found in diclofenac and ibuprofen.
authors.affiliation: a Department of Molecular and Clinical Medicine/Cardiology , Institute of Medicine, Sahlgrenska Academy, University of Gothenburg , Göteborg , Sweden.
authors.forename: Charlotta
authors.initials: C
authors.lastname: Ljungman
authors.affiliation: b Department of Clinical Sciences, Division of Cardiovascular Medicine , Karolinska Institutet, Danderyd Hospital , Stockholm , Sweden.
authors.forename: Thomas
authors.initials: T
authors.lastname: Kahan
authors.affiliation: c Section of Occupational and Environmental Medicine , Institute of Medicine, Sahlgrenska Academy, University of Gothenburg , Göteborg , Sweden.
authors.forename: Linus
authors.initials: L
authors.lastname: Schiöler
authors.affiliation: d Department of Medicine , Centre for Pharmacoepidemiology, Karolinska Institutet , Stockholm , Sweden.|e Public Healthcare Services Committee , Stockholm County Council , Stockholm , Sweden.
authors.forename: Björn
authors.initials: B
authors.lastname: Wettermark
authors.affiliation: f Närhälsan R & D Primary Care , R&D-Centre Skaraborg , Skövde , Sweden.
authors.forename: Kristina B
authors.initials: KB
authors.lastname: Boström
authors.affiliation: g Department of Neurobiology, Care Sciences and Society, Division of Family Medicine , Karolinska Institutet , Stockholm , Sweden.
authors.forename: Jan
authors.initials: J
authors.lastname: Hasselström
authors.affiliation: f Närhälsan R & D Primary Care , R&D-Centre Skaraborg , Skövde , Sweden.
authors.forename: Per
authors.initials: P
authors.lastname: Hjerpe
authors.affiliation: a Department of Molecular and Clinical Medicine/Cardiology , Institute of Medicine, Sahlgrenska Academy, University of Gothenburg , Göteborg , Sweden.
authors.forename: Karin
authors.initials: K
authors.lastname: Manhem
mesh_terms: D000368:Aged; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000494:pharmacology / Q000627:therapeutic use*; D001794:Blood Pressure / Q000502:physiology*; D002319:Cardiovascular System / Q000503:physiopathology*; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D006973:Hypertension / Q000188:drug therapy* / Q000473:pathology; D008297:Male; D011320:Primary Health Care; D012307:Risk Factors; D013548:Sweden
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal
keywords: Hypertension; blood pressure; non-steroidal anti-inflammatory drugs (NSAID); primary health care