NSAIDs and High Blood Pressure: What You Should Know

If you're trying to control hypertension, you may be interested to know whether there are any anti-inflammatory drugs that do not affect blood pressure. All nonsteroidal anti-inflammatory drugs (NSAIDs) pose a risk of worsening blood pressure. But, there are other pain relievers you can take.

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NSAIDs are a type of anti-inflammatory medication available over the counter or by prescription, according to the U.S. Food & Drug Administration (FDA). They are among the most commonly used medications for fever and pain, and they're also used to treat menstrual cramps, colds, the flu, headaches and arthritis.

NSAIDs work by blocking the production of chemicals, called prostaglandins, that cause inflammation, per the American College of Rheumatology. NSAIDs also can reduce fever, swelling and redness due to inflammation.

"NSAIDs reduce inflammation in the tendons, joints and muscles. However, these medications also affect the kidneys' regulation of salt and can worsen blood pressure, particularly at high doses," says Benjamin J. Hirsh, MD, director, Preventive Cardiology, Northwell Health's Sandra Atlas Bass Heart Hospital in Manhasset, New York.

All NSAIDs pose some risk of worsening blood pressure, according to Dr. Hirsh. "They all affect blood flow to the kidneys, which raises blood pressure if there is a significant reduction of blood flow or kidney function," he says. "To make them safer, staying hydrated therefore becomes even more important to increase blood volume and blood flow to the kidney. So you can take them, but it is best at lower doses and with plenty of hydration."

Dr. Hirsh recommends sticking to ibuprofen (Advil/Motrin), naproxen (Aleve) and aspirin over other NSAIDs. Tylenol, as it is not an NSAID, does not affect blood pressure, and may be OK for you to take. But you should check with your doctor to be sure about your particular situation, he says.

It should also be noted that some anti-inflammatory drugs won't interfere with blood pressure, according to Dr. Hirsh. "Other anti-inflammatory medications include drugs used to treat autoimmune disorders such as colitis and lupus, which include Remicade and methotrexate," Dr. Hirsh says. "These drugs, similar to statins and colchicine, which treat heart and blood vessel inflammation (amongst other conditions), do not affect blood pressure."

The most common general side effects of NSAIDs are nausea, stomach upset and heartburn, according to the University of Wisconsin-Madison School of Medicine and Public Health (UW Health). It's important to note that you do not take it on an empty stomach, and you should not use NSAIDs for more than 10 days without speaking with your doctor.

UW Health notes that NSAIDs can also increase your risk of stroke, heart attack, internal bleeding and other health problems. People over age 65 and those with heart, liver, stomach, intestinal diseases or kidney diseases face greater risk of problems that may come with taking NSAIDs.

And if you're pregnant or breastfeeding, you should consult with your doctor about whether you can take NSAIDs.

UW Health says you should also speak with your doctor if you want to take NSAIDs and have any of the following:

• Bleeding problems.
• Anemia.
• Stomach pain or upset stomach.
• Ulcers or a history of intestinal or stomach bleeding.
• Heartburn.
• A habit of consuming more than three alcoholic beverages per day, which can increase your risk of stomach bleeding.
• Heart, kidney or liver disease.
• High blood pressure.

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