Paracetamol is one of the most popular drugs used to treat pain and fever available without a prescription.
It is the drug of choice in patients that cannot be treated with non-steroidal anti-inflammatory drugs (NSAID).
In a study from the University of Edinburgh, scientists found long-term paracetamol use is linked to a strong increase in their blood pressure.
This could increase the risk of heart disease and strokes in people with high blood pressure.
The researchers suggest patients who have a long-term prescription for the painkiller, usually used for the treatment of chronic pain, should opt for the lowest effective dose for the shortest possible time.
Paracetamol was often suggested as a safer alternative to another class of painkillers called non-steroidal anti-inflammatory drugs (NSAIDs), which are known to increase blood pressure and risk of heart disease.
In the study, 110 patients with a history of high blood pressure were prescribed one gram of paracetamol four times a day—a routinely prescribed dose in patients with chronic pain—or a matched placebo for two weeks.
All patients received both treatments, with the order randomized and blinded.
That prescribed paracetamol saw a strong increase in their blood pressure, compared with those taking the placebo.
This rise was similar to that seen with NSAIDs and might be expected to increase the risk of heart disease or stroke by around 20 percent.
The research team says the findings should lead to a review of long-term paracetamol prescriptions to patients—particularly those with high blood pressure, or those at particular risk of heart disease or stroke.
The team says this is not about short-term use of paracetamol for headaches or fever, which is, of course, fine—but it does indicate a newly discovered risk for people who take it regularly over the longer term, usually for chronic pain.
This study clearly shows that paracetamol—the world’s most used drug—increases blood pressure, one of the most important risk factors for heart attacks and strokes.
Doctors and patients together should consider the risks versus the benefits of long-term paracetamol prescription, especially in patients at risk of cardiovascular disease.
The researchers would recommend that clinicians start with a low dose of paracetamol, and increase the dose in stages, going no higher than needed to control pain.
Given the substantial rises in blood pressure seen in some of our patients, there may be a benefit for clinicians to keep a closer eye on blood pressure in people with high blood pressure who newly start paracetamol for chronic pain.
If you care about blood pressure, please read studies about how diets could help lower high blood pressure, and 3 grams of omega-3s a day keep high blood pressure at bay.
The study was conducted by Dr. Iain MacIntyre et al and published in the scientific journal Circulation.
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