Women & Hypertension

Reference: Epidemiology Non-Narcotic Analgesic Dose and Risk of Incident Hypertension in US Women Hypertension September 2005;46:500. The journal Hypertension is owned by the American Heart Association. John P. Forman; Meir J. Stampfer; Gary C. Curhan These authors are associated with Harvard Medical School. Perspectives From Authors • Clinicians commonly believe that NSAID's have the potential to harm the kidneys and cause gastrointestinal bleeding. • Clinicians commonly hold that ac­etaminophen is safe, but this study questions that common belief. • "These data add further support to the hypothesis that acetaminophen and NSAID's may independently elevate the risk of hypertension." • "Given their [NSAID's and acetamin-ophen's] common consumption and the high prevalence of hypertension, our results have substantial public health implications, and suggest that these agents be used with greater cau­tion." Key Points From Dan Murphy: 1. Acetaminophen [Tylenol, Atasol, Anacin-3, Panadol, Excedrin {has ac­etaminophen, aspirin, and caffeine}], ibuprofen [Motrin, Advil, Nuprin, Medipren], and aspirin are the most commonly used drugs in the United States. 2. Compared with women who did not use acetaminophen, older women who took >500 mg per day had a 93% increased risk of hypertension. 3. Younger women who took >500 mg per day had a 99% increased risk of hypertension. 4. For nonsteroidal anti-inflammatory drugs, older women who took >500 mg per day had a 78% increased risk of hypertension. 5. Older women whose usual dose of NSAID was >800 mg per day had a 120% higher risk of hypertension compared with nonusers. 6. Compared with nonusers of acetamin­ophen, older women who consumed >500 mg per day for headache had a 240% increased risk of hyperten­sion. 7. In older women without headache who consumed >400 mg per day of NSAID, there was a 75% increased risk of hypertension compared to nonusers. 8. In older women without headache who consumed >400 mg per day of NSAID, there was a 270% increased risk of hypertension compared to nonusers. 9. Younger women who took >500 mg per day had a 60% increased risk of hypertension. 10. Compared with nonusers of acet­aminophen, younger women who consumed >500 mg per day for headache had a 370% increased risk of hypertension. 11. Higher daily doses of acetaminophen and nonsteroidal anti-inflammatory drugs significantly and independently increase the risk of hypertension in women. 12. Both nonsteroidal anti-inflammatory drugs (NSAID's) and acetaminophen [Tylenol] impair renal function. 13. Acetaminophen [Tylenol] causes hypertension because it depletes glutathione (GSH) leading to renal endothelial dysfunction. 14. Clinicians commonly understand that NSAID's have the potential to harm the kidneys and cause gastroin­testinal bleeding. 15. Clinicians commonly do NOT understand that acetaminophen is NOT safe, and causes significant hypertension. A 1978 graduate of Western States Chiropractic College, Dr. Dan Murphy is on the faculty of Life Chiropractic College West, and is the Vice President of the Internation­al Chiropractic Association. For more information, visit www.danmurphydc.com.\