Acetaminophen has been always considered as a safer alternative to Nonsteroidal Anti Inflammatory Drugs (NSAIDs), and their use regarding blood pressure and cardiovascular health. 

This medication is widely used as first-line therapy for chronic pain because of this perceived safety and the assumption that, unlike NSAIDs, it has little or no effect on the blood pressure (BP). 

Now, in a recently published study, researchers from the University of Edinburgh, in Edinburgh, Scotland have evaluated the use and safety of acetaminophen in patients with hypertension. The study was published in the journal Circulation. 

Study Development and Results 

The study was a double-blind, placebo-controlled, crossover study in which 110 participants were included and were randomized to receive 1 g of acetaminophen 4 times daily or matched placebo for 2 weeks followed by a 2 week washout period before crossing over to the alternate treatment. 

At the start and end of each period, 24-hour ambulatory blood pressures were measured. The primary outcome was the comparison of the change in the mean daytime systolic blood pressure from baseline to the end of the treatment in both arms. 

A total of 103 participants completed the study. The researchers found that regular acetaminophen use resulted in a significant increase in mean daytime systolic blood pressure of about 5 mm Hg when compared with placebo, which can increase the risk of cardiovascular disease. 

According to the researchers the blood pressure increase is similar to that observed with NSAIDs and it could be expected to increase the risk of cardiovascular disease by about 20%, which led to the researchers to question the safety of regular acetaminophen use  and its possible long term effects. 

Sources:

Dr. Rob Hicks. (2022, Feb 17). El uso prolongado de paracetamol aumenta la presión arterial.. Medscape. Retrieved from:
https://espanol.medscape.com/verarticulo/5908583?ecd=socpd_fb_rem-traf_mscp_2022mar09-paracetamolbloodpressure-ID5908583_md_inlang-es-mx-latam-int&fbclid=IwAR1SwrlLkLrAsBVZbXfm97LDZKWAPCk_BvvcJp-zYngaXrWsuzl78e58KzY_aem_Ab8BgUZyWDuPb8fZDax1e6RHAzLEdS9JBBtwgfXuww8yKgSw1Jf7-K39bJoBXsPbziMLKjLXsZqLeypZ9UnoZwR2A4JRs0E2r6zzL_FK0X7W1FDDh5NjRG53RvHzzyu-hR8 

Iain M. Maclntyre, et al. Regular Acetaminophen Use and Blood Pressure in People With Hypertension: The PATH-BP Trial. Circulation. 2022;145:416–423. https://doi.org/10.1161/CIRCULATIONAHA.121.056015 

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