The Effects of Nonsteroidal Anti-Inflammatory Drugs on Blood Pressure in Hypertensive Patients

Nonsteroidal anti-inflammatory drugs (NSAIDs) are ubiquitous medications used by a wide range of people from otherwise healthy normotensive patients to hypertensive patients with many significant comorbidities. Through a variety of mechanisms related to prostaglandin inhibition, including sodium retention and vasoconstriction, these agents may increase blood pressure. This leads to potentially detrimental effects. A review of the current literature regarding this topic yielded 2 meta-analyses and 10 randomized controlled trials. There is evidence of small blood pressure increases in normotensive patients taking NSAIDs approximating +1.1 mm Hg. Patients with treated hypertension show variable increases with NSAID treatment, ranging up to +14.3 mm Hg for systolic pressure and +2.3 mm Hg for diastolic blood pressure. Most antihypertensive medications seem to have decreased effects with concomitant NSAID administration, with the exception of calcium channel blockers. Given the current literature, it appears that NSAIDs increase blood pressure in patients with controlled-hypertension, but the quantity of this increase is variable. If possible, patients who have hypertension should avoid taking NSAIDs.