Painkiller Risk: High Blood Pressure

Many over-the-counter (OTC) painkillers can push your blood pressure higher. They can even be dangerous.

Acetaminophen (Tylenol) is often the pain reliever of choice for people with high blood pressure (hypertension) because most other options are types of nonsteroidal anti-inflammatory drugs like ibuprofen (Motrin, Advil) or naproxen (Naprosyn, Aleve), which can raise blood pressure.

The most widely used medicines in the world -- over-the-counter pain drugs -- raise a person's risk of high blood pressure. It's true for men as well as for women, suggest new findings from Gary C. Curhan, MD, ScD, and colleagues at Brigham and Women's Hospital and Harvard Medical School, Boston. The drugs in question include:

NSAIDs such as ibuprofen (brand names include Advil and Motrin) and naproxen (brand names include Aleve and Naprosyn)
Acetaminophen (brand names include Tylenol)
Aspirin

"Even though these medications can be bought without a prescription, you have to think twice before taking them," Curhan tells WebMD. Curhan's team studied more than 16,000 male health professionals who did not already have high blood pressure. Their average age was 65. Four years after entering the study, nearly 2,000 of the men had developed high blood pressure. High blood pressure -- called "the silent killer" by the American Heart Association -- can lead to stroke, heart attack, heart failure, or kidney failure.

More Blood Pressure Risk With Daily Painkillers

The study found that, compared with men who did not use pain relievers, the risk of high blood pressure:

Went up 38% in men who took NSAIDs six or seven days a week.
Went up 34% in men who took acetaminophen six or seven days a week.
Went up 26% in men who took aspirin six or seven days a week.

That doesn't sound like a lot. But since the drugs are so widely used, the impact is huge. Curhan estimates that a 65-year-old man has a 3% annual risk of high blood pressure. With daily painkiller use, that risk becomes 4% a year. That 1% difference seems small, but it multiplies over time. Over just four years, a man's 12% risk of high blood pressure becomes 16%. The findings aren't a total surprise, says Steven Nissen, MD, chairman of the Cleveland Clinic's department of cardiovascular medicine and president of the American College of Cardiology. "There has been a suspicion that all of these analgesics -- even a so-cal led safe analgesic like acetaminophen -- can raise blood pressure," Nissen tells WebMD. He notes that the design of the study does not definitively prove that these drugs raise the risk of high blood pressure. Only a full-scale clinical trial can do that. But Nissen says it's "probably true" that acetaminophen and other common painkillers raise blood pressure.

'Over-the-Counter' Doesn't Mean 'Safe'

Nissen warns that just because you can buy a drug without a prescription doesn't mean it's safe. "Some of the most risky medications out there you can buy over the counter," he says. For some people, the drugs' risks outweigh their benefits. For others, the benefits still far outweigh the risks. "This doesn't mean you should never take these drugs," Curhan says. "But if you are taking them long term, it is important to talk to your health care provider to see if there are alternative ways of preventing your symptoms." Curhan and colleagues report their findings in the Feb. 26 issue of Archives of Internal Medicine.