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NSAIDs MAY INCREASE ANTIHYPERTENSIVE THERAPY IN THE ELDERLY.

How important is the tendency of nonsteroidal anti- inflammatory drugs (NSAIDs) to raise blood pressure? This case-control study compared the use of NSAIDs among 9411 New Jersey Medicaid patients (65 years or older) who started antihypertensive medication between 1981 and 1990 with that of randomly selected controls from the same database.

Forty-one percent of patients who received antihypertensive medication used NSAIDs during the year before the index date versus 26 percent of controls. After adjusting for age, sex, race, nursing home residence, and other factors, recent NSAID users (those using NSAIDs during the 60 days before the index date) were at greater risk for initiating antihypertensive therapy (odds ratio, 1.66) than controls. There was evidence of a dose-response effect; adjusted odds ratios for starting antihypertensive therapy ranged from 1.55 for patients who received low daily doses of NSAIDs to 1.82 for those who received high doses.

Comment: There are several possible explanations for the association between NSAIDs and antihypertensive therapy found in this study. One possibility is that NSAIDs users received more intensive medical attention. Nonetheless, the findings are consistent with our understanding of the pathophysiology of NSAIDs and support the practice of tapering these drugs in patients with borderline hypertension.

— TH Lee

Published in Journal Watch General Medicine September 30, 1994

Citation(s):

Gurwitz JH et al. Initiation of antihypertensive treatment during nonsteroidal anti-inflammatory drug therapy. JAMA 1994 Sep 14 272 781-786.

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