Dr Chris on the link between paracetamol and heart disease

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High blood pressure, also known as hypertension, is the precursor of serious medical emergencies, including a heart attack and a stroke. While certain lifestyle habits represent an obvious risk factor for the condition, others like targeting your pain with pills might not be that straightforward.

The Harvard Medical School reports that “popular” painkillers, including ibuprofen and naproxen, have been known to boost blood pressure.

The latest pain remedy to join this list is acetaminophen, better known as paracetamol, the journal Circulation reports.

This painkiller has been linked to hypertension when taken in regular doses.

“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,” the British Heart Foundation explains.

In case you’re not aware, NSAIDs include the likes of ibuprofen, naproxen, high-dose aspirin and more, according to the NHS.

However, researchers from the University of Edinburgh say that people who follow a long-term paracetamol treatment should consider opting for the lowest effective dose for the shortest possible time, based on their findings.

The study looked at 110 people with high blood pressure randomly given one 1,000 milligrams (mg) of acetaminophen or a placebo four times a day for two weeks. 

This dose is routinely prescribed to patients with chronic pain, notes the British Heart Foundation.

However, this amount also tends to be the “generally recommended maximum daily amount for healthy adults”, adds the Harvard Medical School. 

After two weeks, the participants switched so both groups would follow both treatments.

The research found that while taking acetaminophen, the participants’ blood pressure rose on average by five points.

This increase is similar to the rise observed when taking NSAIDs.

 

What’s worse, this could be translated to about 20 percent increase of the risk for heart disease and stroke.

The research team urges that their findings should lead to a review of long-term paracetamol use.

Principal Investigator Professor David Webb, Chair of Therapeutics and Clinical Pharmacology at the University of Edinburgh, said: “We 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.”

Fortunately, a sporadic use of paracetamol doesn’t seem to be a cause for concern.

“If you take paracetamol occasionally to manage an isolated headache or very short bouts of pain, these research findings should not cause unnecessary concern,” states the British Heart Foundation.

When it comes to the long-term users, the advice stays to stick the lowest possible dose for the shortest possible time.

It could also be worth reviewing with a doctor whether there’s an ongoing need to take medications.

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