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Cited by 102Blood Pressure and Hypertension StudiesEicosanoids and Hypertension PharmacologyInflammatory mediators and NSAID effects

The DOI matches its Crossref record; 17 of the 18 references it cites were found in a registry or an index.

Effect of indomethacin on blood pressure in elderly people with essential hypertension well controlled on amlodipine or enalapril

Morgan, T. O., Anderson, A., Bertram, D.·2000·American Journal of Hypertension
DOI 10.1016/s0895-7061(00)01204-8
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Abstract

Arthritis and hypertension are frequent comorbidities in the elderly hypertensive population. Nonsteroidal anti-inflammatory drugs are often used to relieve pain in arthritic patients but a side effect is sodium retention and consequent elevation of blood pressure (BP). The effect of dihydropyridine calcium blocking drugs is relatively independent of sodium intake, whereas the angiotensin-converting enzyme (ACE) inhibitors' effects can be blunted by a high-sodium diet. This study compared the effects of indomethacin with placebo in elderly patients with essential hypertension who had been controlled with amlodipine or enalapril. Indomethacin 50 mg twice daily or placebo was administered for 3 weeks in a double-blind crossover study to patients controlled with amlodipine or enalapril. The response was assessed by ambulatory BP measurement. Indomethacin raised BP and lowered pulse rates in patients taking enalapril but had little effect in patients receiving amlodipine. The difference caused by indomethacin between the two groups was 10.1/4.9 mm Hg increase in BP and a 5.6 beats/min fall in pulse in people taking enalapril. Addition of indomethacin to patients taking either drug caused a rise in weight and a fall in plasma renin. It is postulated that the effect is due to inhibition of prostaglandin synthesis, which causes sodium retention. In patients taking amlodipine, the fall in plasma renin ameliorates the effect of sodium retention on BP. In patients taking enalapril, plasma renin falls but this is not translated into an effect because of the blockage of converting enzyme. Thus, the full effect of sodium retention on BP is expressed. In patients treated with indomethacin, fewer patients may respond to ACE inhibitors. However, the major problem is the patient who intermittently takes indomethacin or other nonsteroidal anti-inflammatory drugs, which, if a person is treated by an ACE inhibitor causes BP to go out of control. In such patients amlodipine would appear to be a preferred choice to enalapril.

Overview

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Crossref · 10.1016/s0895-7061(00)01204-8

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Research works printed but not linked: 2

  1. 1993, Journal of hypertension, 11, S338
  2. 1992, Kidney international, 41, S78

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Metadata

Authors
Morgan, T. O., Anderson, A., & Bertram, D.
Affiliations
The University of Melbourne (AU)
Corresponding author
Morgan, T. O.
ORCID
Venue
American Journal of Hypertension
Publisher
Oxford University Press (OUP)
Published
2000-11-01
Volume
13
Issue
11
Pages
1161-1167
ISSN
  • 0895-7061 (ISSN-L)
  • 1941-7225
DOI
10.1016/s0895-7061(00)01204-8
OpenAlex
W2082572643
Cited by
102
References
18
Citations by year
2024: 1 · 2023: 1 · 2022: 3 · 2021: 2 · 2019: 1 · 2018: 8 · 2017: 3 · 2016: 2 · 2014: 2 · 2013: 4 · 2012: 4
FWCI
4.71
Type
journal article
Language
en
Open access
closed
Locations
  • American Journal of Hypertension (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Blood Pressure and Hypertension Studies
  • Life Sciences › Biochemistry, Genetics and Molecular Biology › Biochemistry › Eicosanoids and Hypertension Pharmacology
  • Health Sciences › Medicine › Pharmacology (medical) › Inflammatory mediators and NSAID effects
Keywords
indomethacin, essential hypertension, elderly patients, amlodipine, enalapril, nonsteroidal anti-inflammatory drugs, sodium retention, blood pressure, plasma renin, prostaglandin synthesis, calcium channel blockers, ACE inhibitors, ambulatory blood pressure, pulse rate, weight gain
MeSH terms
Adult, Aged, Aged, 80 and over, Anti-Inflammatory Agents, Non-Steroidal, Blood Pressure, Body Weight, Double-Blind Method, Drug Interactions, Dyspepsia, Enalapril, Female, Humans, Hypertension, Indomethacin, Male, Middle Aged, Nausea, Pain, Renin, Abdominal Pain, Amlodipine

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