In a new study, researchers found that salt in soluble paracetamol is linked to a much higher risk of heart attacks, stroke, heart failure and death.
Doctors have warned that people should try to avoid taking dissolving, fizzy paracetamol that contains salt, following the findings.
In the study, the team tested nearly 300,000 patients registered with UK general practitioners (GPs).
Sodium, one of the main components of salt, is often used to help drugs such as paracetamol (also known as acetaminophen) dissolve and disintegrate in water.
However, effervescent and soluble formulations of 0.5 g tablets of paracetamol can contain 0.44 and 0.39 g of sodium respectively.
If a person took the maximum daily dose of two 0.5 g tablets every six hours, they would consume 3.5 and 3.1 g of sodium respectively—a dose that exceeds the total daily intake of 2 g a day recommended by the World Health Organization.
Other formulations exist that contain an extremely small amount of sodium or none at all.
Too much salt in diets is known to be a major public health problem and is associated with an increased risk of cardiovascular disease (CVD) and death among patients with high blood pressure.
However, there is inconsistent evidence of similar risk for people with normal blood pressure and it would be unethical to conduct a randomized controlled trial to look at this.
The team looked at 4,532 patients with high blood pressure who had been prescribed sodium-containing paracetamol and compared them with 146,866 patients with high blood pressure who had been prescribed paracetamol without sodium.
They found the risk of heart attack, stroke or heart failure after one year for patients with high blood pressure taking sodium-containing paracetamol was 5.6% (122 cases of CVD), while it was 4.6% (3051 CVD cases) among those taking non-sodium-containing paracetamol.
The risk of death was also higher; the one-year risk was 7.6% (404 deaths) and 6.1% (5,510 deaths), respectively.
There was a similar increased risk among patients without high blood pressure.
They also found that the risk of cardiovascular disease and death increased as the duration of sodium-containing paracetamol intake increased.
The team says that clinicians and patients should be aware of the risks associated with paracetamol that contains sodium and avoid unnecessary consumption, especially when the medication is taken for a long period of time.
If you care about painkillers, please read studies that common painkillers may harm your heart, kidneys, sleep and bodyweight, and common painkillers may increase fall risk in people with cognitive decline.
For more information about heart health, please see recent studies about how to control your cholesterol effectively to prevent heart attacks and strokes, and results showing this common food may strongly increase heart disease risk.
The study is published in European Heart Journal and was conducted by Professor Chao Zeng et al.
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