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Ask
the Pharmacist By Ron and Marla Chapleau |
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Q: Can I take an anti-inflammatory if I have high blood pressure? A: This is a question that arises almost daily in the pharmacy which is not surprising, considering that one in 20 visits to a physician is related to prescriptions for anti-inflammatories (also known as NSAID’s which stands for non-steroidal anti-inflammatory drugs) and up to 1:3 of adults may have high blood pressure. In a typical adult with high blood pressure, the use of an NSAID (such as Aleve, Advil, Celebrex, Arthrotec, meloxicam, etc.) can increase their readings by on average 5 mm Hg. In most patients who are relatively well-controlled on their current medications and lifestyle changes, this would be considered insignificant and the NSAID could be safely used on an occasional basis. However, more drastic elevations can occur in hypertensive patients who are elderly, obese, have kidney disease, diabetes, heart failure or liver disease. In these patients, the benefits must be carefully weighed against the potential risks by their physician. Anytime patients with high blood pressure start taking NSAIDs on a regular basis (daily use for one week or more), they should monitor their blood pressure to see what the impact is. As well, an NSAID can make certain classes of blood pressure medications less effective. The combination of an NSAID with an ACE inhibitor (Mavik, Coversyl, ramipril, enalapril) or an ARB (Micardis, Avapro, candesartan) can worsen blood pressure and kidney function. If the patient is taking a diuretic (water pill) with the ACE inhibitor or ARB, the addition of an NSAID could push a patient into kidney failure.
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None of the
available NSAIDs seems to increase blood pressure more or less than
the others. However, if the patient also has cardiovascular disease
(such as high cholesterol) then naproxen would be the best choice as
it seems to have less cardiovascular risk. For patients on an ACE or ARB who require regular use of NSAIDs, switching their blood pressure drug to a Calcium Channel Blocker is an option that is less likely to be affected by the anti-inflammatory. For more information about this or any other health-related questions, contact the pharmacists at Gordon Pharmasave, Your Health and Wellness Destination Scrolling stops when you move your mouse inside the scroll area. You can click on the ads for more
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