| An
estimated 30 million Americans over the age of 35 have arthritis, and 12 million
of those take antihypertensive drugs. Nonsteroidal
anti-inflammatory drugs and COX-2 selective inhibitors are the most widely used
arthritis medications and are well known to increase systolic blood pressure,
particularly in patients who are already hypertensive. A
new study reported in the April issue of Rheumatology suggest that physicians
should be careful in selecting arthritis medications for hypertensive patients
to prevent further increases in their blood pressure and risk of cardiovascular
events.
Led by Dr.
Gurkirpal Singh, of Stanford University School of Medicine, the
researchers investigated the impact of increased blood pressure
levels in arthritis patients caused by medications prescribed
by their physicians.
The
researchers also found that even small increases in systolic blood pressure can
have startling effects on the rates of ischemic heart disease and stroke in patients
with both arthritis and hypertension. "It
is impotant that clinicians who treat patients with osteoarthritis or rheumatoid
arthritis accurately weigh the potential risks of these medications against their
benefits," concluded the researchers.
In
an accompanying editorial, Dr. Richard Day, a rheumatologist at the University
of New South Wales in Australia, said it is reasonable for physicians to take
the researchers' suggestion seriously. "It
also follows that we will need to be more vigilant in monitoring our patients'
blood pressures and more careful in the selection and review of the medicines
we and others prescribe," he added. Other
sources: Journal of Rheumatology 2003;30:714-9
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