December 2, 2022

Paracetamol heart attack risk: study shows increased risks for people with high blood pressure

Researchers from the University of Edinburgh have recommended doctors consider the risks and benefits for patients taking it for several months.

Paracetamol is widely used internationally as a short-term remedy for various ailments, but it can also be prescribed to manage chronic pain.

One in 10 people in Scotland – half a million people – were prescribed the painkiller in 2018.

Paracetamol pills and packages. Credit: PA

What does the paracetamol study reveal?

The study followed 110 volunteers, with two-thirds of the participants taking medication for high blood pressure or hypertension.

In the randomized trial, they were asked to take 1g of paracetamol four times a day for two weeks, which is a common dose for patients with chronic pain.

They were then given placebo pills for another two weeks.

The trial found that paracetamol raised blood pressure, ‘one of the strongest risk factors for heart attacks and strokes’ – far more so than a placebo, the Edinburgh clinical pharmacologist said , Professor James Dear.

Is paracetamol safe to take long term?

Scientists argue that taking a painkiller for fevers and headaches is safe.

Principal investigator Dr Iain MacIntyre, consultant in clinical pharmacology, at NHS Lothian, said: “This is not for short-term use of paracetamol for headache or fever, which is , of course, good.”

The experts simply say that more research on more people over a longer period of time is needed to confirm the report’s findings.

“Firstly, it is unclear whether the observed increase in blood pressure would be maintained with longer term use of paracetamol,” said Dr Dipender Gill, Professor of Clinical Pharmacology and Therapeutics at St George’s, University from London.

Dr Dipender Gill argued that “many unknowns remain” as a result of the study and went on to say: “Secondly, it is not known for certain whether an increase in blood pressure attributable to the use of paracetamol would cause increased risk of cardiovascular disease”.

The Edinburgh study is not the first to look at long-term use of the painkiller.

A large US study had previously identified a link between long-term paracetamol use and an increased risk of heart attacks – however, it could not prove that one caused the other.

Smaller studies have also been conducted which have also been unable to confirm the link.

What is the follow-up to the study on paracetamol?

Although the Edinburgh researchers could not explain how paracetamol could raise blood pressure, they said their findings should lead to a review of long-term paracetamol prescriptions.

Further research in people with normal, healthy blood pressure, over a longer period of time, is needed “to confirm the risks and benefits of the wider use of paracetamol”, said Dr Richard Francis, of the Stroke Association.

Expert advice on paracetamol

Following the study, researchers advised doctors to start patients with chronic pain on as low a dose of paracetamol as possible.

Doctors should also closely monitor patients with high blood pressure who are at risk for heart disease.

“If you are concerned about the risks of pain medication, you should speak to a healthcare professional to explore your options.” said Dr. Benjamin Ellis, consultant rheumatologist at Versus Arthritis.

For more information on paracetamol, including side effects and other advice, visit the NHS website.