NSAID–antihypertensive drug interactions: Which outpatients are at risk for a rise in systolic blood pressure?
Background Management guidelines for drug–drug interactions between non-steroidal anti-inflammatory drugs (NSAIDs) and antihypertensives recommend blood pressure monitoring in hypertensive patients. We measured the short-term effect of initiating NSAIDs on systolic blood pressure (SBP) in users of a...
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| Veröffentlicht in: | European journal of preventive cardiology 2015-01, Vol.22 (1), p.91-99 |
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| container_title | European journal of preventive cardiology |
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| creator | Floor-Schreudering, Annemieke Smet, Peter AGM De Buurma, Henk Kramers, Cornelis Tromp, P Chris Belitser, Svetlana V Bouvy, Marcel L |
| description | Background
Management guidelines for drug–drug interactions between non-steroidal anti-inflammatory drugs (NSAIDs) and antihypertensives recommend blood pressure monitoring in hypertensive patients. We measured the short-term effect of initiating NSAIDs on systolic blood pressure (SBP) in users of antihypertensives, aiming to investigate which outpatients are at risk for an increase in SBP in daily clinical practice.
Design
A cohort study with a nested case-control design in Dutch community pharmacies.
Methods
Patients with a drug–drug interaction alert for a newly initiated NSAID and antihypertensive were interviewed and their SBP was measured at T0, after one week (T1) and after two weeks (T2). We evaluated risk factors for exceeding a predefined limit of change (PLoC) in SBP (≥10 mmHg to ≥140 mmHg) at T1 and T2 versus T0.
Results
For 112 patients the SBP at T0 was measured. Two patients were excluded (T0 SBP ≥180 mmHg). PLoC was exceeded in 10 patients (10.4%) at T1 and in seven patients (8.0%) at T2. Patients using etoricoxib (odds ratio (OR), 21.0; 95% confidence interval (CI), 3.7–120.6) and patients using >1 defined daily dose of an NSAID (OR, 3.3; 95% CI, 1.1–10.0) were at increased risk of a rise in SBP.
Conclusions
A newly initiated NSAID has an immediate clinically relevant effect on SBP in some users of antihypertensives. Management guidelines for NSAID-antihypertensive drug–drug interactions should advise SBP monitoring before and after initiation of an NSAID or intensification of NSAID therapy. Monitoring is especially relevant in patients prescribed high dosages of NSAIDs. Etoricoxib should not be used in hypertensive patients. |
| doi_str_mv | 10.1177/2047487313505243 |
| format | Article |
| fullrecord | <record><control><sourceid>sage_cross</sourceid><recordid>TN_cdi_crossref_primary_10_1177_2047487313505243</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sage_id>10.1177_2047487313505243</sage_id><sourcerecordid>10.1177_2047487313505243</sourcerecordid><originalsourceid>FETCH-LOGICAL-c404t-3002941f5eea8d2a701aa3a8ade6b59910b2c59449c7665325dc2ea2ad59d7e33</originalsourceid><addsrcrecordid>eNp1kM9Kw0AQxhdRbKm9e5J9gej-TTZepNR_haIHFY9hkkzbrW0SdjdCb76Db-iTmFLtQXAuMwzf72PmI-SUs3POk-RCMJUok0guNdNCyQPS364iZQw_3M-J7JGh90vWVcyEMOaY9IRiShgd90nz8DSaXH99fEIV7GLToAtYefuOtHTtnNoqoIMi2Lryl_R1YYsFrdvQQLBYBU_BIYVAnfVvdFY7CtsRO4z6jQ_1yhY0X9V1SRuH3rcOr07I0QxWHoc_fUBebm-ex_fR9PFuMh5No6K7LUSSMZEqPtOIYEoBCeMAEgyUGOc6TTnLRaFTpdIiiWMthS4LgSCg1GmZoJQDwna-hau9dzjLGmfX4DYZZ9k2v-xvfh1ytkOaNl9juQd-0-oE0U7gYY7Zsm5d1b3wv-E3TAV5wA</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype></control><display><type>article</type><title>NSAID–antihypertensive drug interactions: Which outpatients are at risk for a rise in systolic blood pressure?</title><source>SAGE Complete A-Z List</source><source>Oxford University Press Journals All Titles (1996-Current)</source><source>MEDLINE</source><source>Alma/SFX Local Collection</source><creator>Floor-Schreudering, Annemieke ; Smet, Peter AGM De ; Buurma, Henk ; Kramers, Cornelis ; Tromp, P Chris ; Belitser, Svetlana V ; Bouvy, Marcel L</creator><creatorcontrib>Floor-Schreudering, Annemieke ; Smet, Peter AGM De ; Buurma, Henk ; Kramers, Cornelis ; Tromp, P Chris ; Belitser, Svetlana V ; Bouvy, Marcel L</creatorcontrib><description>Background
Management guidelines for drug–drug interactions between non-steroidal anti-inflammatory drugs (NSAIDs) and antihypertensives recommend blood pressure monitoring in hypertensive patients. We measured the short-term effect of initiating NSAIDs on systolic blood pressure (SBP) in users of antihypertensives, aiming to investigate which outpatients are at risk for an increase in SBP in daily clinical practice.
Design
A cohort study with a nested case-control design in Dutch community pharmacies.
Methods
Patients with a drug–drug interaction alert for a newly initiated NSAID and antihypertensive were interviewed and their SBP was measured at T0, after one week (T1) and after two weeks (T2). We evaluated risk factors for exceeding a predefined limit of change (PLoC) in SBP (≥10 mmHg to ≥140 mmHg) at T1 and T2 versus T0.
Results
For 112 patients the SBP at T0 was measured. Two patients were excluded (T0 SBP ≥180 mmHg). PLoC was exceeded in 10 patients (10.4%) at T1 and in seven patients (8.0%) at T2. Patients using etoricoxib (odds ratio (OR), 21.0; 95% confidence interval (CI), 3.7–120.6) and patients using >1 defined daily dose of an NSAID (OR, 3.3; 95% CI, 1.1–10.0) were at increased risk of a rise in SBP.
Conclusions
A newly initiated NSAID has an immediate clinically relevant effect on SBP in some users of antihypertensives. Management guidelines for NSAID-antihypertensive drug–drug interactions should advise SBP monitoring before and after initiation of an NSAID or intensification of NSAID therapy. Monitoring is especially relevant in patients prescribed high dosages of NSAIDs. Etoricoxib should not be used in hypertensive patients.</description><identifier>ISSN: 2047-4873</identifier><identifier>EISSN: 2047-4881</identifier><identifier>DOI: 10.1177/2047487313505243</identifier><identifier>PMID: 24042856</identifier><language>eng</language><publisher>London, England: SAGE Publications</publisher><subject>Aged ; Anti-Inflammatory Agents, Non-Steroidal - adverse effects ; Antihypertensive Agents - therapeutic use ; Blood Pressure - drug effects ; Case-Control Studies ; Chi-Square Distribution ; Community Pharmacy Services ; Dose-Response Relationship, Drug ; Drug Interactions ; Drug Prescriptions ; Female ; Humans ; Hypertension - diagnosis ; Hypertension - drug therapy ; Hypertension - physiopathology ; Logistic Models ; Male ; Middle Aged ; Multivariate Analysis ; Netherlands ; Odds Ratio ; Outpatients ; Pyridines - adverse effects ; Risk Assessment ; Risk Factors ; Sulfones - adverse effects ; Time Factors</subject><ispartof>European journal of preventive cardiology, 2015-01, Vol.22 (1), p.91-99</ispartof><rights>The European Society of Cardiology 2013 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav</rights><rights>The European Society of Cardiology 2013 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c404t-3002941f5eea8d2a701aa3a8ade6b59910b2c59449c7665325dc2ea2ad59d7e33</citedby><cites>FETCH-LOGICAL-c404t-3002941f5eea8d2a701aa3a8ade6b59910b2c59449c7665325dc2ea2ad59d7e33</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://journals.sagepub.com/doi/pdf/10.1177/2047487313505243$$EPDF$$P50$$Gsage$$H</linktopdf><linktohtml>$$Uhttps://journals.sagepub.com/doi/10.1177/2047487313505243$$EHTML$$P50$$Gsage$$H</linktohtml><link.rule.ids>314,776,780,21798,27901,27902,43597,43598</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/24042856$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Floor-Schreudering, Annemieke</creatorcontrib><creatorcontrib>Smet, Peter AGM De</creatorcontrib><creatorcontrib>Buurma, Henk</creatorcontrib><creatorcontrib>Kramers, Cornelis</creatorcontrib><creatorcontrib>Tromp, P Chris</creatorcontrib><creatorcontrib>Belitser, Svetlana V</creatorcontrib><creatorcontrib>Bouvy, Marcel L</creatorcontrib><title>NSAID–antihypertensive drug interactions: Which outpatients are at risk for a rise in systolic blood pressure?</title><title>European journal of preventive cardiology</title><addtitle>Eur J Cardiovasc Prev Rehabil</addtitle><description>Background
Management guidelines for drug–drug interactions between non-steroidal anti-inflammatory drugs (NSAIDs) and antihypertensives recommend blood pressure monitoring in hypertensive patients. We measured the short-term effect of initiating NSAIDs on systolic blood pressure (SBP) in users of antihypertensives, aiming to investigate which outpatients are at risk for an increase in SBP in daily clinical practice.
Design
A cohort study with a nested case-control design in Dutch community pharmacies.
Methods
Patients with a drug–drug interaction alert for a newly initiated NSAID and antihypertensive were interviewed and their SBP was measured at T0, after one week (T1) and after two weeks (T2). We evaluated risk factors for exceeding a predefined limit of change (PLoC) in SBP (≥10 mmHg to ≥140 mmHg) at T1 and T2 versus T0.
Results
For 112 patients the SBP at T0 was measured. Two patients were excluded (T0 SBP ≥180 mmHg). PLoC was exceeded in 10 patients (10.4%) at T1 and in seven patients (8.0%) at T2. Patients using etoricoxib (odds ratio (OR), 21.0; 95% confidence interval (CI), 3.7–120.6) and patients using >1 defined daily dose of an NSAID (OR, 3.3; 95% CI, 1.1–10.0) were at increased risk of a rise in SBP.
Conclusions
A newly initiated NSAID has an immediate clinically relevant effect on SBP in some users of antihypertensives. Management guidelines for NSAID-antihypertensive drug–drug interactions should advise SBP monitoring before and after initiation of an NSAID or intensification of NSAID therapy. Monitoring is especially relevant in patients prescribed high dosages of NSAIDs. Etoricoxib should not be used in hypertensive patients.</description><subject>Aged</subject><subject>Anti-Inflammatory Agents, Non-Steroidal - adverse effects</subject><subject>Antihypertensive Agents - therapeutic use</subject><subject>Blood Pressure - drug effects</subject><subject>Case-Control Studies</subject><subject>Chi-Square Distribution</subject><subject>Community Pharmacy Services</subject><subject>Dose-Response Relationship, Drug</subject><subject>Drug Interactions</subject><subject>Drug Prescriptions</subject><subject>Female</subject><subject>Humans</subject><subject>Hypertension - diagnosis</subject><subject>Hypertension - drug therapy</subject><subject>Hypertension - physiopathology</subject><subject>Logistic Models</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Multivariate Analysis</subject><subject>Netherlands</subject><subject>Odds Ratio</subject><subject>Outpatients</subject><subject>Pyridines - adverse effects</subject><subject>Risk Assessment</subject><subject>Risk Factors</subject><subject>Sulfones - adverse effects</subject><subject>Time Factors</subject><issn>2047-4873</issn><issn>2047-4881</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2015</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp1kM9Kw0AQxhdRbKm9e5J9gej-TTZepNR_haIHFY9hkkzbrW0SdjdCb76Db-iTmFLtQXAuMwzf72PmI-SUs3POk-RCMJUok0guNdNCyQPS364iZQw_3M-J7JGh90vWVcyEMOaY9IRiShgd90nz8DSaXH99fEIV7GLToAtYefuOtHTtnNoqoIMi2Lryl_R1YYsFrdvQQLBYBU_BIYVAnfVvdFY7CtsRO4z6jQ_1yhY0X9V1SRuH3rcOr07I0QxWHoc_fUBebm-ex_fR9PFuMh5No6K7LUSSMZEqPtOIYEoBCeMAEgyUGOc6TTnLRaFTpdIiiWMthS4LgSCg1GmZoJQDwna-hau9dzjLGmfX4DYZZ9k2v-xvfh1ytkOaNl9juQd-0-oE0U7gYY7Zsm5d1b3wv-E3TAV5wA</recordid><startdate>20150101</startdate><enddate>20150101</enddate><creator>Floor-Schreudering, Annemieke</creator><creator>Smet, Peter AGM De</creator><creator>Buurma, Henk</creator><creator>Kramers, Cornelis</creator><creator>Tromp, P Chris</creator><creator>Belitser, Svetlana V</creator><creator>Bouvy, Marcel L</creator><general>SAGE Publications</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope></search><sort><creationdate>20150101</creationdate><title>NSAID–antihypertensive drug interactions: Which outpatients are at risk for a rise in systolic blood pressure?</title><author>Floor-Schreudering, Annemieke ; Smet, Peter AGM De ; Buurma, Henk ; Kramers, Cornelis ; Tromp, P Chris ; Belitser, Svetlana V ; Bouvy, Marcel L</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c404t-3002941f5eea8d2a701aa3a8ade6b59910b2c59449c7665325dc2ea2ad59d7e33</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2015</creationdate><topic>Aged</topic><topic>Anti-Inflammatory Agents, Non-Steroidal - adverse effects</topic><topic>Antihypertensive Agents - therapeutic use</topic><topic>Blood Pressure - drug effects</topic><topic>Case-Control Studies</topic><topic>Chi-Square Distribution</topic><topic>Community Pharmacy Services</topic><topic>Dose-Response Relationship, Drug</topic><topic>Drug Interactions</topic><topic>Drug Prescriptions</topic><topic>Female</topic><topic>Humans</topic><topic>Hypertension - diagnosis</topic><topic>Hypertension - drug therapy</topic><topic>Hypertension - physiopathology</topic><topic>Logistic Models</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Multivariate Analysis</topic><topic>Netherlands</topic><topic>Odds Ratio</topic><topic>Outpatients</topic><topic>Pyridines - adverse effects</topic><topic>Risk Assessment</topic><topic>Risk Factors</topic><topic>Sulfones - adverse effects</topic><topic>Time Factors</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Floor-Schreudering, Annemieke</creatorcontrib><creatorcontrib>Smet, Peter AGM De</creatorcontrib><creatorcontrib>Buurma, Henk</creatorcontrib><creatorcontrib>Kramers, Cornelis</creatorcontrib><creatorcontrib>Tromp, P Chris</creatorcontrib><creatorcontrib>Belitser, Svetlana V</creatorcontrib><creatorcontrib>Bouvy, Marcel L</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><jtitle>European journal of preventive cardiology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Floor-Schreudering, Annemieke</au><au>Smet, Peter AGM De</au><au>Buurma, Henk</au><au>Kramers, Cornelis</au><au>Tromp, P Chris</au><au>Belitser, Svetlana V</au><au>Bouvy, Marcel L</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>NSAID–antihypertensive drug interactions: Which outpatients are at risk for a rise in systolic blood pressure?</atitle><jtitle>European journal of preventive cardiology</jtitle><addtitle>Eur J Cardiovasc Prev Rehabil</addtitle><date>2015-01-01</date><risdate>2015</risdate><volume>22</volume><issue>1</issue><spage>91</spage><epage>99</epage><pages>91-99</pages><issn>2047-4873</issn><eissn>2047-4881</eissn><abstract>Background
Management guidelines for drug–drug interactions between non-steroidal anti-inflammatory drugs (NSAIDs) and antihypertensives recommend blood pressure monitoring in hypertensive patients. We measured the short-term effect of initiating NSAIDs on systolic blood pressure (SBP) in users of antihypertensives, aiming to investigate which outpatients are at risk for an increase in SBP in daily clinical practice.
Design
A cohort study with a nested case-control design in Dutch community pharmacies.
Methods
Patients with a drug–drug interaction alert for a newly initiated NSAID and antihypertensive were interviewed and their SBP was measured at T0, after one week (T1) and after two weeks (T2). We evaluated risk factors for exceeding a predefined limit of change (PLoC) in SBP (≥10 mmHg to ≥140 mmHg) at T1 and T2 versus T0.
Results
For 112 patients the SBP at T0 was measured. Two patients were excluded (T0 SBP ≥180 mmHg). PLoC was exceeded in 10 patients (10.4%) at T1 and in seven patients (8.0%) at T2. Patients using etoricoxib (odds ratio (OR), 21.0; 95% confidence interval (CI), 3.7–120.6) and patients using >1 defined daily dose of an NSAID (OR, 3.3; 95% CI, 1.1–10.0) were at increased risk of a rise in SBP.
Conclusions
A newly initiated NSAID has an immediate clinically relevant effect on SBP in some users of antihypertensives. Management guidelines for NSAID-antihypertensive drug–drug interactions should advise SBP monitoring before and after initiation of an NSAID or intensification of NSAID therapy. Monitoring is especially relevant in patients prescribed high dosages of NSAIDs. Etoricoxib should not be used in hypertensive patients.</abstract><cop>London, England</cop><pub>SAGE Publications</pub><pmid>24042856</pmid><doi>10.1177/2047487313505243</doi><tpages>9</tpages><oa>free_for_read</oa></addata></record> |
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| identifier | ISSN: 2047-4873 |
| ispartof | European journal of preventive cardiology, 2015-01, Vol.22 (1), p.91-99 |
| issn | 2047-4873 2047-4881 |
| language | eng |
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| source | SAGE Complete A-Z List; Oxford University Press Journals All Titles (1996-Current); MEDLINE; Alma/SFX Local Collection |
| subjects | Aged Anti-Inflammatory Agents, Non-Steroidal - adverse effects Antihypertensive Agents - therapeutic use Blood Pressure - drug effects Case-Control Studies Chi-Square Distribution Community Pharmacy Services Dose-Response Relationship, Drug Drug Interactions Drug Prescriptions Female Humans Hypertension - diagnosis Hypertension - drug therapy Hypertension - physiopathology Logistic Models Male Middle Aged Multivariate Analysis Netherlands Odds Ratio Outpatients Pyridines - adverse effects Risk Assessment Risk Factors Sulfones - adverse effects Time Factors |
| title | NSAID–antihypertensive drug interactions: Which outpatients are at risk for a rise in systolic blood pressure? |
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