Pain Relievers and High Blood Pressure

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Many common over-the-counter (OTC) pain relievers have been shown to increase blood pressure. This effect can occur in both people with normal blood pressure and in those with already diagnosed high blood pressure (hypertension). Many common medications, not just pain relievers, can affect blood pressure because of the way that they affect signaling systems within the body. It is not commonly appreciated that pain relief drugs can have side effects that involve changes in blood pressure.

Non-steroidal anti-inflammatory drugs (NSAIDs)

NSAIDs like aspirin, ibuprofen, naproxen, and others all have the capacity to increase blood pressure. The average increase is small, but the actual amount of increase can vary widely from individual to individual. This effect occurs at doses that are typically used for pain relief and reduction of inflammation. Moreover, these drugs can reduce the effect of many types of drugs used to treat elevated blood pressure. The effect on blood pressure seems to be due to a reduction in excretion of sodium and increased retention of water. Studies of NSAIDs showed that only low-dose aspirin (81 mg a day) did not have measurable effects on blood pressure.

Acetaminophen

Acetaminophen, the active ingredient in Tylenol and other drugs, has been shown in some studies to cause a mild increase in blood pressure, but it hasn't been associated with stroke or heart attack. Still, this medication has its own side effects and poses a risk of liver damage when taken in overly large doses. Prolonged use at high doses can also cause kidney failure.

Options for people with high blood pressure

If you have high blood pressure or heart conditions and would like to take pain control medications, discuss your options with your doctor beforehand. Most experts agree that acetaminophen and aspirin are the safest pain relief choices for people with high blood pressure. However, not everyone should use aspirin. Ask your doctor if aspirin is safe for you if you take medications for high blood pressure. Aspirin may also cause ulcers, heartburn, and upset stomach, and it can be dangerous to take if you have gout, liver disease, rheumatic fever, or if used in children. Pregnant women also should not take aspirin as it can be unsafe for both mother and baby.

Alternatives for pain relief

If you do not want to take pain medications for relief of headache or other mild aches and pains, there are other alternatives. Many people find that ice packs (for acute injuries) and heating pads (for chronic overuse injuries) can bring relief. Relaxation techniques like meditation, imagery, or yoga can be used to help manage pain. Physical activity may help with some kinds of pain, like that of arthritis. Finally, acupuncture and other nontraditional techniques can help some people with mild to moderate pain.

REFERENCES:

Dawson, J. et al. "Acetaminophen use and change in blood pressure in a hypertensive population." Journal of Hypertension 2013.

Dedier, J. et al. "Nonnarcotic analgesic use and the risk of hypertension in U.S. women." Hypertension 40.5 (2002): 604-608.

Radack, K. L. et al. "Ibuprofen interferes with the efficacy of antihypertensive drugs. A randomized, double-blind, placebo-controlled trial of ibuprofen compared with acetaminophen." Annals of Internal Medicine 107.5 (1987): 628-635.

Sudano, I. et al. "Acetaminophen increases blood pressure in patients with coronary artery disease." Circulation 122.18 (2010) 1789-1796.


Last Editorial Review: 8/21/2013