Salt, which is used as a ‘hidden’ ingredient in some types of paracetamol, could lead to an increased risk of heart disease and death, according to new research.
Academics have warned that people often take soluble painkillers unaware they contain sodium, which manufacturers include to help the tablets break down more easily in water.
This lack of awareness means paracetamol users are more likely to exceed their recommended daily salt intake of 2g, they said. Some might even exceed this threshold through medication alone, as some pills contain up to 0.44g of salt.
Although most forms of paracetamol do not contain sodium, experts suggest that those that do should post a health warning on their packaging.
Professor Chao Zeng, from Central South University in Changsha, China, who led the study, thinks doctors should always prescribe salt-free versions of the drug to minimize risk.
“People should pay attention not only to the salt intake in their diet, but also not to overlook the hidden salt intake of medicines in their cabinet,” he said.
Professor Zeng added: “Our results suggest reviewing the safety profile of effervescent and soluble paracetamol.”
The study, published in the European journal of the heartwas based on an analysis of data collected from 790 UK medical practices between 2000 and 2017.
The researchers looked at a group of 300,000 patients between the ages of 60 and 90, half of whom suffered from high blood pressure. Some received paracetamol containing sodium, while the others did not.
Among the cohort with high blood pressure, the risk of developing heart failure or having a stroke was 5.6% for those who took paracetamol with salt for a year and 4.6% for those who received sodium-free medications.
Similarly for people without high blood pressure, the likelihood of heart disease was higher in patients whose paracetamol contained salt. The risk was 4.4% for those who did and 3.7% for those who did not.
The international team of researchers also found that the risk of death during the follow-up period was higher for those taking paracetamol with salt.
Commenting on the study, two academics from the George Institute for Global Health in Australia said the risks posed by these drugs were increasing as “fizzy” pills became more popular.
They added: “There is an immediate need for consumer protection against these risks. The most plausible and effective strategy is likely to be mandatory labeling of all drugs containing significant amounts of sodium with a front-of-pack warning label.
However, Professor Sir Nilesh Samani, medical director of the British Heart Foundation, said the study was limited as it did not contain data on how much salt people were consuming in their diets.
“It’s also important to remember that observational studies like these can only show an association, rather than proving cause and effect,” he said.
Research has suggested that 170 out of 10,000 adults in Britain use medicines containing sodium, with older people more likely to take it than younger people.
Additional reports per AP