When I’m seeing a patient for high blood pressure, we often talk about medications for lowering blood pressure.
But I also ask if they’re taking medications that can raise blood pressure.
Yes, unfortunately, certain medications can raise your blood pressure. The most common culprits are over-the-counter pain relievers. These are the ones you can get at the pharmacy without a prescription. It’s important to be aware of how the different types of pain relievers affect blood pressure.
Nonsteroidal antiinflammatory drugs (NSAIDs) raise blood pressure
NSAIDs are over-the-counter pain relievers that most of us have taken for minor aches and pains, fever, and cold symptoms. Examples include:
- Ibuprofen (brand names include Motrin, Advil)
- Naproxen (Naprosyn, Aleve)
These can be sneaky. It might not be obvious if you’re taking an NSAID, especially if you’re not familiar with brand names or the box simply says “Pain reliever.” Also, watch out for
cold and sinus formulations which may include an NSAID.
Read the label carefully or
check with the pharmacist to see if the medication is an NSAID.
Some NSAIDs do require a prescription. These include:
- Celecoxib (e.g. Celebrex)
- Meloxicam (e.g. Mobic)
- Piroxicam (e.g. Feldene)
- Indomethacin (e.g. Indocin)
On average,
NSAIDs raise the top number (systolic blood pressure) by 3 mm Hg and the bottom number (diastolic blood pressure) by 2 mm. That might not seem like much, but the effect varies between individuals. NSAIDs might not affect one person’s blood pressure but might raise another person’s blood pressure by 5 or 10 mm Hg.
NSAIDs also interfere with some blood pressure medications. So taking ibuprofen on a consistent basis, for example, may work against the effects of blood pressure medications.
Which NSAIDs are the worst for blood pressure?
All NSAIDs have the potential to raise your blood pressure. There’s not enough research to conclusively point to which NSAIDs raise blood pressure the most. But we have a few hints.
This
study looked at 3 NSAIDs: ibuprofen, naproxen, and celecoxib. It showed that
ibuprofen was associated with greater increases in blood pressure compared to naproxen and celecoxib. But the researchers looked back at historical data and used statistical analyses to tease out the results. So we have to be careful about drawing firm conclusions on studies like this.
However, a
clinical trial (a stronger type of research study) found similar results.
Ibuprofen raised systolic blood pressure by almost 4 mm Hg compared to celecoxib in people who took the medications every day for arthritis. Note that the research was sponsored by the company that makes celecoxib. However, the academic authors were responsible for publishing results.
What about acetaminophen (Tylenol)?
Compared to NSAIDs, the research on acetaminophen and blood pressure is less clear. In this
systematic review, some studies showed that acetaminophen raises blood pressure while others have not.
But acetaminophen is probably safer than NSAIDs for blood pressure.
Does baby aspirin raise blood pressure?
Aspirin attacks inflammation in a manner similar to NSAIDs. But this
review of research suggests that short term use of
low-dose aspirin (e.g. 81 mg) doesn’t interfere with blood pressure medications. That’s good news if you’re already taking blood pressure medications and worried about adding aspirin. (However, the overall health impact of low-dose aspirin is another topic.)
How to balance the risk
It’s hard to go through life without taking something for aches and pains. Here are a few tips for striking a balance between pain relief and blood pressure:
- Try acetaminophen first. Consider trying acetaminophen instead of NSAIDs, especially if you or your doctor are concerned about your blood pressure.
- Watch your sodium. If you do take NSAIDs, limit the sodium (salt) in your diet. NSAIDs can interfere with how your kidneys get rid of sodium. Too much sodium raises blood pressure.
- Don’t go overboard. Take pain relievers only for as long as you really need them. Don’t exceed the doses recommended on the label.
- Monitor your blood pressure. Learn how to measure your own blood pressure at home. Note any trends in your blood pressure when you’re taking NSAIDs.
Of course, keep in touch with your doctor to discuss how to get adequate relief from your symptoms and keep your blood pressure under control.
Have you noticed an increase in your blood pressure after taking ibuprofen or other NSAIDs?
