Gaziano J Michael
Divisions of Aging, Preventive Medicine and Cardiovascular Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA.
Am J Cardiol. 2006 May 8;97(9A):10-6. doi: 10.1016/j.amjcard.2006.02.018. Epub 2006 Mar 30.
In 2004, individuals in the United States spent >$2.5 billion on over-the-counter (OTC) nonsteroidal anti-inflammatory drugs (NSAIDs) and filled >100 million NSAID prescriptions. The most commonly used OTC analgesics include aspirin, acetaminophen, and nonaspirin NSAIDs. Nonnarcotic analgesics are generally considered safe when used as directed but do have the potential to increase blood pressure in patients with hypertension treated with antihypertensives. This is important because hypertension alone has been correlated with an increased risk of cardiovascular disease or stroke. Small increases in blood pressure in patients with hypertension also have been shown to increase cardiovascular morbidity and mortality. Therefore, when nonnarcotic analgesics are taken by patients with hypertension, there may be important implications. This review explores the potential connection among analgesic agents, blood pressure, and hypertension, and discusses possible mechanisms by which analgesics might cause increases in blood pressure. This is followed by a summary of data on the relation between analgesics and blood pressure from both observational and randomized trials.
2004年，美国民众在非处方（OTC）非甾体抗炎药（NSAIDs）上的花费超过25亿美元，NSAIDs的处方量超过1亿份。最常用的非处方镇痛药包括阿司匹林、对乙酰氨基酚和非阿司匹林类NSAIDs。非麻醉性镇痛药按指导使用时通常被认为是安全的，但对于正在接受抗高血压治疗的高血压患者，确实有可能升高血压。这一点很重要，因为仅高血压就与心血管疾病或中风风险增加相关。高血压患者血压的小幅升高也已被证明会增加心血管疾病的发病率和死亡率。因此，高血压患者服用非麻醉性镇痛药可能会产生重要影响。本综述探讨了镇痛药、血压和高血压之间的潜在联系，并讨论了镇痛药可能导致血压升高的潜在机制。随后总结了观察性试验和随机试验中关于镇痛药与血压关系的数据。
