Regular Acetaminophen Use and Blood Pressure in People With Hypertension: The PATH-BP Trial
Acetaminophen is widely used in practice as first-line therapy for chronic pain because of its considered safety and the assumption that, unlike nonsteroidal anti-inflammatory drugs, it has a minimum effect or no effect on blood pressure (BP). Although previous observational studies suggest that acetaminophen may elevate BP, clinical trials are lacking. Hence, Iain M. MacIntyre and colleagues conducted a study under the title “Regular Acetaminophen Use and Blood Pressure in People With Hypertension: The PATH-BP Trial” published in the American Heart Association journal. The summary of this study is given below:
To investigate the effects of regular acetaminophen dosing on BP in hypertensive individuals.
It is a double-blind, placebo-controlled, crossover study conducted with 110 individuals. The subjects were randomized to receive 1 gram acetaminophen 4 times daily or matched placebo for two weeks followed by a 2-week washout period before starting with the alternate treatment. 24-hour ambulatory BPs were assessed at the beginning and end of each treatment period. The main outcome was a comparison of the change in mean daytime SBP from baseline to end of treatment between the placebo and acetaminophen groups.
The study concludes that regular intake of 4 g acetaminophen/day increases systolic BP in individuals with hypertension by ≈5 mm Hg. This effect on BP was similar in both, treated and untreated groups. This finding highlights the increased risk of cardiovascular disease in patients on acetaminophen and sparks concerns regarding the safety of regular acetaminophen treatment.
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