Low-dose aspirin does not interfere with the blood pressure-lowering effects of antihypertensive therapy.
Abstract
BACKGROUND: It has been reported that aspirin (ASA) may interfere with the blood pressure (BP)-lowering effect of various antihypertensive agents and attenuate the beneficial effects of angiotensin-converting enzyme (ACE) inhibitors in patients with congestive heart failure. METHODS AND RESULTS: Data from the Hypertension Optimal Treatment (HOT) Study, in which 18 790 intensively treated hypertensive patients were randomized to either ASA 75 mg daily or placebo for 3.8 years (with a 15% reduction in cardiovascular events and a 36% reduction in myocardial infarction in ASA-treated patients), were reanalysed for the whole group of patients and for various subgroups with particular attention to the possible effects of ASA on BP and renal function. In ASA-treated and placebo-treated patients: (1) systolic blood pressure (SBP) and diastolic blood pressure (DBP) values achieved with antihypertensive treatment were superimposable, with clinically irrelevant differences; (2) these superimposable SBP and DBP were achieved with antihypertensive therapies, that were quantitatively and qualitatively similar, and (3) changes in serum creatinine and in estimated creatinine clearance and the number of patients developing renal dysfunction were also similar. Furthermore, the cardiovascular benefits of ASA were of the same magnitude in hypertensive patients receiving or not receiving ACE-inhibitors. CONCLUSIONS: Even long-term, low-dose ASA does not interfere with the BP-lowering effect of antihypertensive agents, including combinations with ACE inhibitors, or with renal function. No negative interaction occurs between ACE inhibition and the cardiovascular benefits of small dose of ASA. Our conclusions cannot be extended to larger doses of ASA, or to patients with congestive heart failure.
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Low-dose aspirin does not have COX-2-inhibiting or blood pressure-increasing effects, as indicated by results from the HOT study.
“In contrast, low-dose aspirin does not have COX-2–inhibiting or BP-increasing effects, as indicated by results from the HOT study (Hypertension Optimal Treatment).191”
From Resistant Hypertension: Detection, Evaluation, and Management: A Scientific Statement From the American Heart Association (2018) · cites this paper as [191]
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- Authors
- Zanchetti, A., Hansson, L., Leonetti, G., Rahn, K.-H., Ruilope, L., Warnold, I., & Wedel, H.
- Affiliations
- University of Milan (IT)
- Uppsala University (SE)
- Corresponding author
- Zanchetti, Alberto
- Venue
- Journal of Hypertension
- Published
- 2002-05
- Volume
- 20
- Issue
- 5
- Pages
- 1015-1022
- ISSN
- 0263-6352 (ISSN-L)
- OpenAlex
- W2075032872
- Cited by
- 89
- References
- 27
- Citations by year
- 2025: 1 · 2024: 5 · 2023: 1 · 2022: 2 · 2020: 1 · 2019: 4 · 2018: 3 · 2017: 3 · 2016: 1 · 2015: 3 · 2014: 3 · 2013: 4 · 2012: 13
- FWCI
- 3.64
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Hypertension (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Blood Pressure and Hypertension Studies
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Antiplatelet Therapy and Cardiovascular Diseases
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Biochemistry › Eicosanoids and Hypertension Pharmacology
- Keywords
- low-dose aspirin, antihypertensive therapy, antihypertensive effect, ACE inhibitors, drug interactions, renal function, creatinine clearance, serum creatinine, hypertension, cardiovascular benefits, HOT study
- MeSH terms
- Aged, Antihypertensive Agents, Aspirin, Blood Pressure, Cardiovascular Diseases, Cardiovascular System, Diastole, Dose-Response Relationship, Drug, Double-Blind Method, Drug Interactions, Female, Humans, Hypertension, Kidney, Male, Middle Aged, Platelet Aggregation Inhibitors, Systole
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