Patients with high blood pressure on a long-term paracetamol prescription should be given the lowest effective dose, researchers say
Some people who take paracetamol regularly may have an increased risk of heart disease and stroke, new research suggests.
Until recently, paracetamol was assumed to be a completely safe drug for patients with high blood pressure.
However, new findings indicate that the effect on people with the condition is similar to nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, which are known to increase blood pressure and heart disease risk. and also used to manage chronic pain. .
The researchers say that patients who have a long-term prescription for the painkiller, usually for the treatment of chronic pain, should be given the lowest effective dose for the shortest duration possible.
What effect can paracetamol have on people with high blood pressure?
Experts say that increased blood pressure could increase the risk of heart disease or stroke by around 20%.
They suggest the study should lead to a review of long-term paracetamol prescriptions for patients – particularly those with the disease or those at particular risk of heart disease or stroke.
Professor James Dear, Personal Chair of Clinical Pharmacology at the University of Edinburgh, said: “This study clearly shows that paracetamol – the world’s most widely used drug – raises blood pressure, one of the factors greatest risk for heart attacks and strokes.
“Physicians and patients should together consider the risks versus benefits of prescribing paracetamol long-term, particularly in patients at risk for cardiovascular disease.”
He continued: “In summary, we have shown that two weeks of paracetamol treatment increases blood pressure in patients with hypertension (high blood pressure).”
Principal investigator Dr Iain MacIntyre, consultant in clinical pharmacology and nephrology at NHS Lothian, added: ‘This is not a short term use of paracetamol for headache or fever, this which is, of course, fine – but it points to a newly discovered risk for people who take it regularly over the long term, usually for chronic pain.
The study found that after people stopped taking the drug, their blood pressure returned to what it was at the start of the study, suggesting that the drug raised it.
One in three UK adults have high blood pressure
The researchers said they did not have precise figures on people in the UK taking paracetamol long-term and suffering from high blood pressure.
However, it is estimated that one in three UK adults has blood pressure that rises with age, while one in 10 people in Scotland – where the research was carried out – take paracetamol regularly, a figure which is likely to be similar somewhere else.
The study evaluated 110 patients with a history of high blood pressure who were each prescribed 1 g of paracetamol four times a day – a dose commonly prescribed to patients with chronic pain – or a placebo for two weeks each.
The results showed that there was a significant increase in blood pressure in those taking the painkiller, compared to those taking the placebo.
According to experts, the study was set up to see a very small effect on blood pressure, but the researchers were surprised to see a much larger impact.
Prof Dear said the research indicates the findings could affect a large number of people, but the scientists pointed out that a limitation of their study was that it did not include patients with chronic pain.
However, there is no reason to think that patients taking paracetamol for pain treatment would have a different blood pressure response than study patients, the researchers say.
Professor Sir Nilesh Samani, Medical Director of the British Heart Foundation, which funded the study, said: “This research shows how quickly regular use of paracetamol can raise blood pressure in people with hypertension who already have an increased risk of heart attacks and strokes.
“This underscores why physicians and patients should regularly check whether there is a continued need to take medication, even something that may seem relatively harmless like paracetamol, and always weigh the benefits against the risks.”
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