Why the study?
Do NSAIDs and COX-2 inhibitors affect blood pressure control and the incidence of cardiovascular events?
Do NSAIDs and COX-2 inhibitors affect blood pressure control and the incidence of cardiovascular events?
NSAIDs and COX-2 inhibitors carry risks of blood pressure destabilization and cardiovascular events, but can be used cautiously in selected patients when anti-inflammatory benefits outweigh these risks.
Answers are grounded in this paper and cite their sources.
May warrant caution with NSAIDs in hypertension or CVD; leaves open precise risk quantification by agent and population.
In recent years, there has been a great deal of evaluation of the cardiovascular (CV) effects of the non-steroidal anti-inflammatory drugs (NSAIDs) and the selective cyclooxygenase-2 (COX-2) inhibitors. In this brief review, the focus is on both effects of the NSAIDs and COX-2 inhibitors on blood pressure and CV events. The literature was searched using PubMed for both clinical trials and observational studies reviewing the relations among NSAIDs, blood pressure, and CV events. Clinical trial results for NSAIDs and COX-2 inhibitors have shown varying levels of destabilization of blood pressure control in treated hypertensive patients as well as variable incident rates of the development of arrhythmias, congestive heart failure, myocardial infarction, and stroke. The non-selective and COX-2 selective NSAIDs can be used with care in selected arthritis patients with hypertension and stable CV disorders (excluding congestive heart failure and moderate to severe kidney dysfunction) when the individual clinical benefit of anti-inflammatory therapy outweighs the CV and gastrointestinal risk.
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White et al. (2011) studied this question.
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