Leading Headache Pills ‘Put Strain On The Heart’

Regularly taking some of the most popular painkillers on the market is linked to a much greater risk of stroke and heart attack from higher blood pressure, according to research published yesterday. The study looked at the effects of paracetamol, aspirin and non-steroidal anti-inflammatory drugs (NSAIDs).

Participants in a large American study who took paracetamol, aspirin or non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen six or seven days per week over a two-year period were between a quarter to a third more likely to be diagnosed with high blood pressure. Those who took 15 pills per week, regardless of type, have almost a 50 per cent risk of higher blood pressure than those who do not.

More than five million Britons with osteoarthritis, migraines or back pain either buy the drugs over the counter regularly or are prescribed them, though dosages differ. Those diagnosed with hypertension – high blood pressure – are at greater risk of stroke, heart attack and disease, and kidney failure.

The findings could pose a dilemma for some arthritis sufferers who have been told to switch to over-the-counter painkillers because of fears of heart problems linked to some prescription drugs.

Graham MacGregor, the professor of cardiovascular medicine at St George’s Hospital, London, and chairman of the Blood Pressure Association, said last night: “High blood pressure is the biggest cause of death and disability in the UK. Even though the increased risks are small in this study, they are important. If you take a couple of paracetamol for a headache, that’s fine, but patients need to be aware if they are on long-term painkillers they need to get their blood pressure checked.”

Researchers led by Dr John Forman, of Harvard Medical School in Boston, Massachusetts, studied 16,000 male volunteers in a long-term research project. They were asked about their use of paracetamol, aspirin and NSAIDs, and whether they had had a diagnosis of high blood pressure in the preceding two years.

Those taking paracetamol, aspirin or NSAIDs six or seven days per week were respectively 34 per cent, 38 per cent and 26 per cent more likely to have been diagnosed with it than those who had not been taking painkillers regularly.

Compared with men who took no pain relief medication, participants who took 15 or more pills each week, irrespective of type, had a 48 per cent higher risk of higher blood pressure.

Writing in the Archives of Internal Medicine, the journal of the American Medical Association, the authors said: “These data add further support to the hypothesis that non-narcotic analgesics independently elevate the risk of hypertension.

“Given their common consumption and the high prevalence of hypertension, our results may have substantial public health implications and suggest that these agents be used with greater caution.”

The researchers said the link with increased blood pressure may be caused by all three painkillers inhibiting the effect of vasodilatory prostaglandins – chemicals that relax the blood vessels.

They also believe paracetamol, the world’s most widely-used painkiller, could promote the accumulation of volatile chemicals called free radicals or impair the functioning of blood vessel lining.

Around 16 million people in Britain have high blood pressure. It rarely has symptoms and is usually only discovered on a visit to the doctor.

Doctors and patient groups stressed that patients should not change their medication without taking medical advice.

Ellen Mason, of the British Heart Foundation, said: “We advise that painkillers should be taken at the lowest possible dose for the shortest amount of time. All medicines have side effects, and if you find yourself in frequent need of pain relief it makes good sense to discuss your health with a pharmacist or GP.

“If you take prescribed painkillers regularly for conditions such as arthritis, which can cause chronic debilitating pain, the relief from symptoms may well outweigh the health risks.”

Prof Alan Silman, of the Arthritis Research Campaign, said: “We should be careful about interpreting these results. We don’t know whether people have a greater risk of high blood pressure because they are taking painkillers or because of the condition they are taking them for.

“Also we should remember high blood pressure has no symptoms. If someone is taking paracetamol regularly it is likely they go to their doctor more often. It is standard to take patients’ blood pressure and so this could be explained by doctors being more likely to pick up their condition.”

Previous US research found women who regularly took paracetamol, NSAIDs or aspirin had increased risks of high blood pressure of 20 per cent, 35 per cent and 21 per cent.

Vioxx, one of the NSAIDs, was taken off the market in 2004 after it was shown those who used it for 18 months or more were at increased risk of heart attacks and strokes.

Dr Geoffrey Brandon, of the Paracetamol Information Centre, which receives funding from the pharmaceutical industry, said:

“As with previous reports this study reports a statistical association between analgesic use and hypertension but fails to show a causal relationship. We do not believe there is any evidence to warrant a recommendation for any change in use of paracetamol.”