The effect of non-steroidal anti-inflammatory drugs and other commonly used non-narcotic analgesics on blood pressure level in adults

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This review explores the blood pressure effects of three non-narcotic analgesics: non-selective non-steroidal anti-inflammatory drugs (NSAID), paracetamol and aspirin. The current evidence suggests that in normotensive, otherwise healthy adults, short-term use (1–2 weeks) of NSAIDs is not associated with a significant increase in blood pressure. Those with existing hypertension are more likely to see a blood pressure elevation, although the magnitude of the effect is less predictable and may vary with age, baseline blood pressure, type of NSAID and concurrent antihypertensive therapy. The magnitude of the blood pressure increase appears to be similar for both NSAIDs and paracetamol, while low-dose aspirin may have more modest effects. In hypertensive adults who experience deterioration of blood pressure control on NSAIDs, there is some, albeit suboptimal, evidence that the blood pressure-raising effects of NSAIDs are less when used in conjunction with dihydropyridine calcium-channel blockers than angiotensin-converting enzyme inhibitors.

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