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Is it okay for patients with uncomplicated hypertension to take NSAIDs such as ibuprofen, naproxyn, celecoxib, etc? Many can … but you need to be careful.
According to the experts at the Natural Medicines Comprehensive Database (NMCD), on average, NSAIDs increase BP by around 5 mmHg in patients with hypertension … but some patients are more susceptible than others.
Elevations are more likely in the elderly … obese men … and patients with diabetes, heart failure, or kidney or liver disease.
The NMCD tells us prescribers, “Tell patients with uncomplicated hypertension that occasional use of NSAIDs is usually okay … but daily use for just one week can reduce BP control.”
They also tell us prescribers:
- Monitor BP if a hypertensive patient starts a chronic NSAID. Explain that NSAIDs can also make BP meds less effective.
- Be careful about combining an NSAID with an ACE inhibitor or ARB … the combo can worsen BP and renal function.
- And watch for the “triple whammy”… an NSAID plus an ACEI or ARB plus a diuretic. This combo can push a patient into acute renal failure.
- Consider using a calcium channel blocker if a patient needs an antihypertensive that is less affected by NSAIDs.
- Don’t expect one NSAID to increase BP more or less than the others.
- Suggest naproxen if a chronic NSAID is needed for a patient with cardiovascular disease … not just hypertension.
- Naproxen seems to be the least likely to increase cardiovascular risk.
Here are some of my other blogs on NSAIDs: