Nonnarcotic analgesic use and the risk of hypertension

Design: Participants in the Nurses' Health Study7 have completed a mailed questionnaire every 2 years, starting in 1976. The study by Dedier and colleagues is based on data collected between 1990 and 1998. In 1990, 85 625 women in the cohort returned the mailed questionnaire: 51 630 of them were included in the study, and the remaining women were excluded because of a reported history of hypertension (n = 27 344), chronic kidney failure (n = 10), failure to answer any of the questions on analgesic use (n = 336), no physical examination between 1988 and 1990 (n = 735) and no physical examination during the study period (n = 5570). The women were asked how many days on average each month they took any of ASA, acetaminophen or other NSAIDs. Dosage and prior duration of analgesic use were not ascertained. Body mass index (BMI), smoking status, age and physical activity were ascertained from the 1990 questionnaire and were updated with each subsequent biennial questionnaire. Alcohol and sodium intake were obtained from the 1990 questionnaire and again in 1994. Diabetes was diagnosed if it had been reported on any biennial questionnaire through 1990, and information on family history of hypertension was obtained from the 1992 questionnaire. Incident hypertension was determined based on answers in biennial questionnaires as to whether a physician had made a new diagnosis of hypertension in the preceding 2 years.