Impact of NSAIDs on cardiovascular risk and hypertension

Abstract

Introduction: 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. Materials and methods: 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. Results: 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. Discussion: 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 antiinflammatory therapy outweighs the CV and gastrointestinal risk.

Keywords

• Cyclooxygenase inhibition
• Non-steroidal antiinflammatory drugs
• Hypertension
• Cardiovascular events.