Do Painkillers Present a Heart Risk for Men?

Feb. 27, 2007 — -- Researchers raised the possibility Monday that common painkillers containing aspirin, ibuprofen and acetaminophen could increase men's risk of high blood pressure.

However, the significance of the findings, as well as their likely impact on physicians' practice, is still up for debate.

The study, published in the current issue of the Archives of Internal Medicine, looked at 16,000 male subjects. Of these men, those who took drugs such as aspirin, Tylenol and Advil for most days in a week were one-quarter to one-third more likely to be diagnosed as having high blood pressure than men who did not.

The study freshens concerns over a possible link between painkillers and high blood pressure, as a previous study in 2002 has suggested the same association in women taking these medications.

Dr. John Forman of Brigham and Women's Hospital in Boston, who led the study, said in a statement that painkillers represent "a potentially preventable cause of high blood pressure."

Risk May Not Be Great

However, not all doctors agree that the findings warrant a change in physicians' practice.

"We've known for 25 years that NSAIDs [a class of painkillers] raise blood pressure, and a recent study showed the same for acetaminophen," says Dr. Steve Nissen, president of the American College of Cardiology.

One of the country's top arthritis experts agrees. "The results are not surprising," says Dr. Marc Hochberg, head of the Division of Rheumatology and Clinical Immunology at the University of Maryland. He says a rise in blood pressure could possibly come from the fluid retention associated with use of the drugs.

Dr. Patrick McBride, associate director of the Preventive Cardiology Program at the University of Wisconsin Medical School, says that if the findings are true, the study shows only a "small difference" in the risk of high blood pressure between those taking painkillers and those who do not.

And Dr. Nortin Hadler, professor of medicine at the University of North Carolina at Chapel Hill, calls the study "Much ado about the miniscule.

"The absolute risk is trivial and probably can't be measured reliably," he says.

More Studies Needed to Confirm Risk

Physicians say more research will likely be necessary to determine if a link exists between painkiller use and high blood pressure in men -- and, if it does, how strong it is.

But such additional research may be important, considering the wide usage of these drugs among consumers in general.

"Given that it's an association study, it's not going to come to any conclusions about causation," says ABC News medical editor Dr. Tim Johnson. "You can't prove that it causes it, and neither can you jump to the conclusion that there is no connection."

Part of the problem with the study also comes from the fact that researchers focused only on men taking painkillers every day -- which means that they could have already been suffering from another malady that caused their high blood pressure.

Also, the painkillers implicated by the researchers all work in different ways, making it less likely that the drugs have something in common that causes high blood pressure.

Patients Should Not Change Regimens … Yet

For patients taking a daily dose of aspirin on the advice of their doctors, the findings may come as a shock. However, Dr. Tim says that these patients should not panic.

"For me, this brings up the practical question of what do people do," he says. "At the very least they ought to talk to their doctor about it and get their blood pressure checked. That's always worth doing."

Most importantly, he says, these patients should not change their regimens without their physicians' approval.

"People who are taking aspirin on the recommendation of their doctors certainly should not stop doing that," Dr. Tim says. "For those people, the benefits of the aspirin for their heart will likely outweigh the risk of high blood pressure."