Stroke Prevention & Atherosclerosis Research Centre, Robarts Research Institute, Western University, London, Ontario, Canada (J.D.S.).
Institute for Translational Medicine and Therapeutics, Department of Systems Pharmacology and Translational Therapeutics, University of Pennsylvania Perelman School of Medicine, Philadelphia (T.G., G.A.F.).
Hypertension. 2022 Sep;79(9):1922-1926. doi: 10.1161/HYPERTENSIONAHA.122.19315. Epub 2022 Jul 7.
Acetaminophen is widely regarded as a safe therapy for pain and fever in patients with cardiovascular disease and those taking anticoagulants. However, recent studies report that acetaminophen, like most other nonsteroidal anti-inflammatory drugs, increases blood pressure, and a formulation containing sodium increases cardiovascular risk. Those findings call into question guidelines recommending acetaminophen for patients with cardiovascular disease and pain, and those taking anticoagulants. We review evidence that acetaminophen has effects in common with nonsteroidal anti-inflammatory drugs, and its influence on coagulation via effects on vitamin K metabolism. Possible alternatives to acetaminophen for patients with pain are discussed.
对乙酰氨基酚被广泛认为是心血管疾病患者和正在服用抗凝剂的患者的安全止痛和退热疗法。然而，最近的研究报告称，对乙酰氨基酚与大多数其他非甾体抗炎药一样，会升高血压，而含有钠的制剂会增加心血管风险。这些发现使得那些推荐将对乙酰氨基酚用于心血管疾病和疼痛患者以及正在服用抗凝剂的患者的指南受到质疑。我们回顾了对乙酰氨基酚与非甾体抗炎药具有共同作用的证据，以及其通过影响维生素 K 代谢对凝血的影响。还讨论了用于疼痛患者的对乙酰氨基酚的可能替代药物。
