Popular Pain Killers May Increase Risk of High Blood Pressure in Women
Frequent use of acetaminophen and ibuprofen may increase risk by approximately 60-90 percent; aspirin does not appear to be associated with high blood pressure in women
BOSTON - Brigham and Women's Hospital (BWH) is a leading source of research on the public health benefits and potential side effects of over-the-counter pain medications, most recently making headlines with the news that aspirin plays virtually no role in preventing cancer. To further define the association between popular painkillers and a suspected link to high blood pressure, a BWH team now reports that with each dose of acetaminophen or ibuprofen, a woman’s risk of high blood pressure increases. The findings are published in the August 15, 2005 online issue of the journal, Hypertension.
Acetaminophen, non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen and naproxen, and aspirin, all over- the-counter painkillers, are the most commonly used drugs in the United States. BWH researchers have now identified a dose-dependent relationship between use of two types of these painkillers - acetaminophen and NSAID - and incidence of hypertension. For example, older women who consumed the highest daily dose of acetaminophen had a 93 percent greater risk of hypertension than non-users.
"Given the wide-spread use of painkillers, especially among women, it is critical to understand the potential side effects associated with frequent, high-dose consumption so that women and their clinicians can make informed decisions about how and when to best use these medications," said John Forman, MD, a hypertension researcher in the Division of Renal Medicine at BWH. "The take-home from this analysis is to highlight a potential risk associated with these medications which are available over the counter, so that these products are used with greater caution."
The researchers looked at the use of painkillers in two groups of women: 1,903 older women (age 51-77) and 3,220 younger women (age 34-53) in the BWH-based Nurses’ Health Study I and Nurses’ Health Study II. The participants reported the frequency of painkiller use in days per month, the number of tablets per day, and the dosage per tablet, allowing the researchers to calculate an "average daily dose." For acetaminophen, greater than 500 mg/day was the highest intake category and for NSAIDs it was greater than 400mg/day. These categories are roughly equivalent to a woman taking one extra strength acetaminophen tablet every day and two non-prescription ibuprofen tablets every day.
Dr. Forman also reports:
· Older women who reported the highest intake of acetaminophen had a 93 percent increased risk of developing hypertension compared to non-users. In the younger women, the risk was elevated two-fold.
· Older women who reported the highest intake of NSAIDs had a 78 percent increased risk of hypertension. In younger women, the risk was elevated by 60 percent
· A significant number of women fell into the "highest intake" category for acetaminophen or NSAID use.
· Aspirin was not associated with risk of hypertension
"We’re not ready to advocate that people abandon using acetaminophen and ibuprofen, however, this study clarifies the dose-dependent relationship and suggests that further research should look to identify populations who may be at greatest risk," said Forman, who is also an instructor in Medicine at Harvard Medical School. "We are making people aware that there are potential health risks to consider whenever these medications are used on a regular basis."
Please contact BWH Media Relations for more information at (617) 534-1600 or BWHMediaRelations@partners.org.
BWH is a 747-bed nonprofit teaching affiliate of Harvard Medical School and a founding member of Partners HealthCare System, an integrated health care delivery network. BWH is committed to excellence in patient care with expertise in virtually every specialty of medicine and surgery. The BWH medical preeminence dates back to 1832 and today that rich history in clinical care is coupled with its national leadership in quality improvement and patient safety initiatives, dedication to educating and training health care professionals, and strength in biomedical research. With $370M in funding and more than 500 research scientists, BWH is an acclaimed leader in clinical, basic and epidemiological investigation - including the landmark Nurses Health Study, Physicians Health Studies, and the Women's Health Initiative. For more information visit www.brighamandwomens.org
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