There is now growing evidence showing that non-steroidal, anti-inflammatory drugs (NSAIDS), e.g., naproxen and ibuprofen, increase the risk of cardiovascular disease (CVD), at least in part by raising blood pressure (BP). It appears that all NSAIDS, with the possible exception of aspirin in low doses (which actually is protective against CVD), increase the risk of CVD deaths. All NSAIDS (including aspirin) can cause severe gastrointestinal bleeding and several thousand Americans die each year as a result of these bleeds. The drug industry developed a new class of NSAIDS called Cox-2 inhibitors (Celebrex, Vioxx) in the hopes there would be less GI bleeding. The danger of GI bleeding, increased BP, and more CVD mortality from all classes of NSAIDS has caused many doctors and people to switch to acetaminophen (Tylenol).

Unfortunately, a new study that followed 5,000+ Nurses (ages 34-77) found that those who took even 1 extra strength pill or 2 regular dose acetaminophen pills daily for several years doubled their risk of developing hypertension (HTN). By contrast NSAIDS increased the risk of developing HTN in these women by about 60 to 80%.1Bottom Line: Given that NSAIDS and acetaminophen are taken regularly by millions of Americans daily, the results of this recent study are disturbing. We have known for years that acetaminophen, particularly in higher doses, impairs kidney function and contributes to kidney failure. No doubt this makes it more difficult for the kidneys to get rid of excess salt and fluid. NSAIDS also appear to impair the kidney’s ability to get rid of excess salt.However, it is likely that if Americans cut their sodium intake to no more than 1500mg/day (and less if they have BP higher than 110/70), the risk of developing HTN from pain medications would be dramatically reduced. It appears that most people with elevated BP and/or compromised kidney function would be better off using aspirin rather than acetaminophen.  By James J. Kenney, PhD, RD, FACN. 1 Hypertension 2005;doi: 10.1161/01.HYP. 000177437.07240.70