NONSTEROIDAL ANTIINFLAMMATORY DRUGS AND BLOOD-PRESSURE IN AN ELDERLY POPULATION

Background. Short-term clinical studies suggest that nonsteroidal anti -inflammatory drugs (NSAIDs) may interfere with the effectiveness of a ntihypertensive therapies. We studied the joint effects of these two c lasses of drugs among subjects participating in the cross-sectional ba seline interview from a population-based cohort study of community-dwe lling elderly. Methods. Blood pressure was recorded by interviewers us ing a standard sphygmomanometer after at least 5 minutes in the sittin g position. Two recordings were made in rapid succession, using the fi rst and fifth Korotkoff sounds. The second recording was used for this study. From respondents' medication container labels, interviewers re corded the name and dosage regimen of each medication used during the preceding two weeks. Results. Persons on antihypertensive therapy taki ng NSAIDs had systolic blood pressures approximately 5 mmHg higher tha n those not taking NSAIDs, and were more likely to have systolic blood pressure above 140 mmHg (odds ratio = 2.19, 95% confidence interval 1 .33, 3.61). These findings could not be explained by difference$ betwe en NSAID users and nonusers in age, relative weight, or the type or do se of antihypertensive regimen. No significant effects of NSAIDs were seen for diastolic blood pressure or among persons not taking antihype rtensive drugs. When analyses were restricted to non-indomethacin NSAI D use, the findings were unchanged. Conclusion. These findings suggest that NSAID use may be an important community reason for loss of pharm acologic control of hypertension.