Effect of omega-3 or other fatty acids on heart disease is negligible finds Cochrane review

Effect of omega-3 or other fatty acids on heart disease is negligible finds Cochrane review

July 19 2018 Cochrane researchers have published research indicating that omega 3 supplements...

DOACs associated with reduced risk of major bleeding compared to warfarin

DOACs associated with reduced risk of major bleeding compared to warfarin

July 11 2018 Direct oral anticoagulants (DOACs) have been associated with reduced risks of major...

Recorded penicillin allergy associated with increased risk of MRSA and C difficile

Recorded penicillin allergy associated with increased risk of MRSA and C difficile

July 3 2018 People who have a record of penicillin allergy are at an increased risk of developing...

MPS advises of need for better awareness of cauda equina red flag symptoms

MPS advises of need for better awareness of cauda equina red flag symptoms

May 9 2018 The Medical Protection Society is advising doctors of a revision to the NICE Clinical...

Anticholinergics linked to increased risk of dementia

Anticholinergics linked to increased risk of dementia

April 30 2018 Anticholinergic drugs used in helping control some involuntary muscle movement...

  • Effect of omega-3 or other fatty acids on heart disease is negligible finds Cochrane review

    Effect of omega-3 or other fatty acids on heart disease is negligible finds Cochrane review

    Thursday, 19 July 2018 10:36
  • DOACs associated with reduced risk of major bleeding compared to warfarin

    DOACs associated with reduced risk of major bleeding compared to warfarin

    Wednesday, 11 July 2018 13:22
  • Recorded penicillin allergy associated with increased risk of MRSA and C difficile

    Recorded penicillin allergy associated with increased risk of MRSA and C difficile

    Tuesday, 03 July 2018 16:51
  • MPS advises of need for better awareness of cauda equina red flag symptoms

    MPS advises of need for better awareness of cauda equina red flag symptoms

    Wednesday, 09 May 2018 16:01
  • Anticholinergics linked to increased risk of dementia

    Anticholinergics linked to increased risk of dementia

    Monday, 30 April 2018 12:20

a blood pressure monitor imageSeptember 4 2017

Prescription strength doses of ibuprofen are associated with increased blood pressure and hypertension compared to celecoxib in patients with osteoarthritis or rheumatoid arthritis. The study has also found ibuprofen to be associated with an increased risk of cardiovascular disease.

 The findings are from the US-based PRECISION-ABPM study, which was designed to determine the blood pressure effects of the selective cyclooxygenase-2 (COX-2) inhibitor celecoxib compared to the non-selective NSAIDs naproxen and ibuprofen. It involved 444 patients, of whom 408 (92%) had osteoarthritis and 36 (8%) had rheumatoid arthritis. All patients had evidence of, or were at increased risk for, coronary artery disease.

Patients were randomised to receive celecoxib (100-200 mg twice a day), ibuprofen (600-800 mg three times a day), or naproxen (375-500 mg twice a day) with matching placebos. The primary endpoint was the change from baseline in 24-hour ambulatory blood pressure after four months.

Celecoxib decreased the average systolic blood pressure measured over 24 hours by -0.3 mmHg while ibuprofen and naproxen increased it by 3.7 and 1.6 mmHg, respectively. The resulting difference of -3.9 mmHg between celecoxib and ibuprofen was significant (p=0.009).

The results were presented at the European Society of Cardiology meeting.

Principal investigator Prof Frank Ruschitzka of the University Heart Centre, Zurich, Switzerland, said: “While celecoxib and naproxen produced either a slight decrease (celecoxib) or a relatively small increase (naproxen) in blood pressure, ibuprofen was associated with a significant increase in ambulatory systolic blood pressure of more than 3 mmHg.”

In addition, “patients receiving ibuprofen had a 61% higher incidence of de novo hypertension compared to those receiving celecoxib.

“PRECISION-ABPM clearly demonstrates that NSAIDs, particularly ibuprofen, may be not as safe as previously thought … since decreasing systolic blood pressure by just 2 mmHg lowers stroke mortality by 10% and ischaemic heart disease mortality by 7%, increases in systolic blood pressure associated with NSAIDs as observed in PRECISION-ABPM should be considered clinically relevant.”

The study was funded by Pfizer.

Link:
ESC announcement         

Clinical News

July 20 2018 Doctors are being reminded to ensure that any patient or other records which may be relevant to the UK Infected Blood Inquiry are not destroyed. Earlier this month, the Inquiry’s Chair, Sir...