Chrischilles E A, Wallace R B
Department of Preventive Medicine and Environmental Health, University of Iowa.
J Gerontol. 1993 May;48(3):M91-6. doi: 10.1093/geronj/48.3.m91.
Short-term clinical studies suggest that nonsteroidal anti-inflammatory drugs (NSAIDs) may interfere with the effectiveness of antihypertensive therapies. We studied the joint effects of these two classes of drugs among subjects participating in the cross-sectional baseline interview from a population-based cohort study of community-dwelling elderly.
Blood pressure was recorded by interviewers using a standard sphygmomanometer after at least 5 minutes in the sitting position. Two recordings were made in rapid succession, using the first and fifth Korotkoff sounds. The second recording was used for this study. From respondents' medication container labels, interviewers recorded the name and dosage regimen of each medication used during the preceding two weeks.
Persons on antihypertensive therapy taking NSAIDs had systolic blood pressures approximately 5 mmHg higher than those not taking NSAIDs, and were more likely to have systolic blood pressure above 140 mmHg (odds ratio = 2.19, 95% confidence interval 1.33, 3.61). These findings could not be explained by differences between NSAID users and nonusers in age, relative weight, or the type or dose of antihypertensive regimen. No significant effects of NSAIDs were seen for diastolic blood pressure or among persons not taking antihypertensive drugs. When analyses were restricted to non-indomethacin NSAID use, the findings were unchanged.
These findings suggest that NSAID use may be an important community reason for loss of pharmacologic control of hypertension.
短期临床研究表明，非甾体抗炎药（NSAIDs）可能会干扰抗高血压治疗的效果。我们在一项基于人群的社区居住老年人队列研究的横断面基线访谈参与者中，研究了这两类药物的联合作用。
访员在受试者坐位至少5分钟后，使用标准血压计记录血压。连续快速测量两次，采用柯氏音第1音和第5音。本研究使用第二次测量结果。访员从受访者的药瓶标签上记录前两周使用的每种药物的名称和用药方案。
接受抗高血压治疗且服用NSAIDs的人的收缩压比未服用NSAIDs的人高约5 mmHg，且更有可能收缩压高于140 mmHg（比值比=2.19，95%置信区间1.33，3.61）。NSAIDs使用者和非使用者在年龄、相对体重或抗高血压治疗方案的类型或剂量方面的差异无法解释这些发现。对于舒张压或未服用抗高血压药物的人，未观察到NSAIDs的显著影响。当分析仅限于非吲哚美辛类NSAIDs的使用时，结果不变。
这些发现表明，使用NSAIDs可能是社区中高血压药物控制不佳的一个重要原因。
