Acetaminophen increases blood pressure in patients with coronary artery disease.


Because traditional nonsteroidal antiinflammatory drugs have been associated with increased risk for acute cardiovascular events, current guidelines recommend acetaminophen as the first-line analgesic of choice on the assumption of its greater cardiovascular safety. This study evaluated the safety of acetaminophen in patients with coronary artery disease. A total of 33 patients with coronary artery disease participated in a randomized, doubleblind, placebo-controlled, crossover study of acetaminophen or placebo (1g 3x/d) on top of standard cardiovascular therapy for 2 weeks. Treatment with acetaminophen resulted in a significant increase in mean systolic (from 122.4±11.9 to 125.3±12.0 mmHg, p=0.02 versus placebo) and diastolic (from 73.2±6.9 to 75.4±7.9 mmHg, p=0.02 versus placebo) ambulatory blood pressures. Heart rate, endothelial function, early endothelial progenitor cells, and platelet function did not change. This is the first study to demonstrate that acetaminophen induces a significant increase in ambulatory blood pressure in patients with coronary artery disease. Use of acetaminophen should be critically evaluated for use in patients at increased cardiovascular risk. Circulation. 2010 Nov 2;122(18):1789-96. PMID: 20956208.


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