Acetaminophen increases blood pressure in patients with coronary artery disease.

Details

Serval ID
serval:BIB_8F93E4839F7C
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Acetaminophen increases blood pressure in patients with coronary artery disease.
Journal
Circulation
Author(s)
Sudano I., Flammer A.J., Périat D., Enseleit F., Hermann M., Wolfrum M., Hirt A., Kaiser P., Hurlimann D., Neidhart M., Gay S., Holzmeister J., Nussberger J., Mocharla P., Landmesser U., Haile S.R., Corti R., Vanhoutte P.M., Lüscher T.F., Noll G., Ruschitzka F.
ISSN
1524-4539[electronic], 0009-7322[linking]
Publication state
Published
Issued date
2010
Volume
122
Number
18
Pages
1789-1796
Language
english
Abstract
BACKGROUND: Because traditional nonsteroidal antiinflammatory drugs are associated with increased risk for acute cardiovascular events, current guidelines recommend acetaminophen as the first-line analgesic of choice on the assumption of its greater cardiovascular safety. Data from randomized clinical trials prospectively addressing cardiovascular safety of acetaminophen, however, are still lacking, particularly in patients at increased cardiovascular risk. Hence, the aim of this study was to evaluate the safety of acetaminophen in patients with coronary artery disease.
METHODS AND RESULTS: The 33 patients with coronary artery disease included in this randomized, double-blind, placebo-controlled, crossover study received acetaminophen (1 g TID) on top of standard cardiovascular therapy for 2 weeks. Ambulatory blood pressure, heart rate, endothelium-dependent and -independent vasodilatation, platelet function, endothelial progenitor cells, markers of the renin-angiotensin system, inflammation, and oxidative stress were determined at baseline and after each treatment period. Treatment with acetaminophen resulted in a significant increase in mean systolic (from 122.4±11.9 to 125.3±12.0 mm Hg P=0.02 versus placebo) and diastolic (from 73.2±6.9 to 75.4±7.9 mm Hg P=0.02 versus placebo) ambulatory blood pressures. On the other hand, heart rate, endothelial function, early endothelial progenitor cells, and platelet function did not change.
CONCLUSIONS: This study demonstrates for the first time that acetaminophen induces a significant increase in ambulatory blood pressure in patients with coronary artery disease. Thus, the use of acetaminophen should be evaluated as rigorously as traditional nonsteroidal antiinflammatory drugs and cyclooxygenase-2 inhibitors, particularly in patients at increased cardiovascular risk.
CLINICAL TRIAL REGISTRATION: URL: http://www.clinicaltrials.gov. Unique identifier: NCT00534651.
Keywords
acetaminophen, blood pressure, coronary disease, endothelium, nonsteroidal antiinflammatory drugs, improves endothelial function, converting enzyme-inhibition, flow-mediated dilation, brachial-artery, cardiovascular events, analgesic use, rheumatoid-arthritis, clinical-trial, healthy-men
Pubmed
Web of science
Open Access
Yes
Create date
24/11/2010 11:35
Last modification date
20/08/2019 14:53
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