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Cited by 140Blood Pressure and Hypertension StudiesEicosanoids and Hypertension PharmacologyInflammatory mediators and NSAID effects

Ibuprofen Interferes with the Efficacy of Antihypertensive Drugs: A Randomized, Double-Blind, Placebo-Controlled Trial of Ibuprofen Compared with Acetaminophen

RADACK, KENNETH L, DECK, COLLEEN C., BLOOMFIELD, SAUL S.·1987·Annals of Internal Medicine
DOI 10.7326/0003-4819-107-5-628
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Abstract

Study Objective: To assess the effects of Ibuprofen on blood pressure control in patients being treated with antihypertensive drugs. Design: Randomized, blinded, placebo-controlled, parallel trial of Ibuprofen compared with acetaminophen and with placebo in 3-week treatment periods. Setting: A general internal medicine clinic at a university hospital. Patients: Forty-five patients with essential hypertension controlled by treatment with at least two antihypertensive drugs were enrolled. Of these, 41 completed the study; treatment was discontinued in 3 of the 15 patients in the Ibuprofen group due to breakage of the drug capsules, and after randomization in 1 of the 14 patients in the placebo group due to unstable angina. All 15 patients in the acetaminophen group completed the study. Interventions: All previous antihypertensive regimens were continued. During the 3-week treatment, Ibuprofen, 400 mg, was administered orally every 8 hours; acetaminophen, 1 g, orally every 8 hours; or placebo, 2 capsules, orally every 8 hours. Measurements and Main Results: In the Ibuprofen group, the mean increase from baseline after 3 weeks of treatment was significant in the average supine diastolic blood pressure (6.4 mm Hg; 95% confidence interval [Cl], 1.05 to 11.75; p = 0.0239); supine mean arterial pressure (6.6 mm Hg; 95% Cl, 1.25 to 11.95; & p = 0.0205); and sitting mean arterial pressure (5.8 mm Hg; 95% Cl, 1.57 to 10.04; p = 0.0123). The mean increase in blood pressure variables in the Ibuprofen group was significantly different compared with the mean increase in the variables in the placebo group after 3 weeks of treatment: supine systolic blood pressure (7.1 mm Hg compared with -4.5 mm Hg; 95% Cl for the difference in means, 2.5 to 20.6; p = 0.0133); supine diastolic pressure (6.4 mm Hg compared with 0.0; 95% Cl for difference in means, 0.87 to 12.4; p = 0.0250); supine mean arterial pressure (6.6 mm Hg compared with -1.5; 95% Cl for difference in means, 2.0 to 14.2; p= 0.0110); sitting systolic pressure (6.8 mm Hg compared with -3.7; 95% Cl for difference in means, 2.0 to 19.0; p = 0.0169); sitting diastolic pressure (5.3 mm Hg compared with -1.1; 95% Cl for difference in means, 0.76 to 12.1; p = 0.0273); and sitting mean arterial pressure (5.8 mm Hg compared with -2.0; 95% Cl for difference in means, 1.5 to 14.1; p = 0.0169). When compared with the acetaminophen group after 3 weeks of treatment, the Ibuprofen group also showed statistically significant changes in supine diastolic and mean arterial pressures, and sitting diastolic and mean arterial pressures. Conclusions: Ibuprofen can interfere with blood pressure control in certain patients with treated mild-to-moderate hypertension. Further clinical studies are needed to document these findings and determine which patients are most likely to have an ibuprofen-related impairment in blood pressure control.

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Authors
RADACK, K. L., DECK, C. C., & BLOOMFIELD, S. S.
Affiliations
  • University of Cincinnati (US)
  • Cincinnati, Ohio
Corresponding author
RADACK, KENNETH L
Venue
Annals of Internal Medicine
Publisher
American College of Physicians
Published
1987-11-01
Volume
107
Issue
5
Pages
628-635
ISSN
  • 0003-4819 (ISSN-L)
  • 1539-3704
DOI
10.7326/0003-4819-107-5-628
OpenAlex
W1973757442
Cited by
140
References
27
Citations by year
2024: 2 · 2023: 2 · 2022: 3 · 2021: 1 · 2019: 1 · 2018: 1 · 2017: 3 · 2016: 1 · 2015: 8 · 2014: 3 · 2013: 5 · 2012: 8
FWCI
7.33
Type
journal article
Language
en
Open access
closed
Licence
www.acpjournals.org/journal/aim/text-and-data-mining (tdm)
Locations
  • Annals of Internal Medicine (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 › Inflammatory mediators and NSAID effects
Keywords
ibuprofen, antihypertensive drugs, essential hypertension, drug interactions, blood pressure control, paracetamol, nonsteroidal anti-inflammatory drugs, diastolic blood pressure, mean arterial pressure, combination therapy, adverse drug reactions, drug discontinuation, angina pectoris
MeSH terms
Acetaminophen, Adrenergic beta-Antagonists, Adult, Aged, Antihypertensive Agents, Blood Pressure, Clinical Trials as Topic, Double-Blind Method, Female, Humans, Hypertension, Ibuprofen, Male, Middle Aged, Random Allocation, Renin

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