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...

Women of childbearing potential must be on Pregnancy Prevention Programme if taking valproate

Women of childbearing potential must be on Pregnancy Prevention Programme if taking valproate

April 27 2018 Women and girls of childbearing potential must no longer take valproate medicines...

Buprenorphine may be safer than methadone in opioid substitute therapy, study suggests

Buprenorphine may be safer than methadone in opioid substitute therapy, study suggests

April 23 2018 Buprenorphine has been found to have lower rates of overdose death than methadone...

Class of diabetes drug linked to increased risk of irritable bowel disease

Class of diabetes drug linked to increased risk of irritable bowel disease

March 29 2018 A study has shown that dipeptidylpeptidase-4 inhibitors may increase the risk of...

  • 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
  • Women of childbearing potential must be on Pregnancy Prevention Programme if taking valproate

    Women of childbearing potential must be on Pregnancy Prevention Programme if taking valproate

    Friday, 27 April 2018 12:12
  • Buprenorphine may be safer than methadone in opioid substitute therapy, study suggests

    Buprenorphine may be safer than methadone in opioid substitute therapy, study suggests

    Monday, 23 April 2018 16:59
  • Class of diabetes drug linked to increased risk of irritable bowel disease

    Class of diabetes drug linked to increased risk of irritable bowel disease

    Thursday, 29 March 2018 11:49

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

May 23 2018 Over 2,000 patients were removed from GP lists due to allegations of violence or threats in 2017. A further 10,000 were removed due to a break down in the relationship between the GP and...
May 18 2018 New guidance to support the integration of community pharmacy services into primary care homes (PCHs) has been published.  The National Association of Primary Care’s report looks at ways...