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Article: Acetaminophen increases blood pressure in patients with coronary artery disease

TitleAcetaminophen increases blood pressure in patients with coronary artery disease
Authors
Issue Date2010
PublisherLippincott Williams & Wilkins. The Journal's web site is located at http://circ.ahajournals.org
Citation
Circulation, 2010, v. 122 n. 18, p. 1789-1796 How to Cite?
AbstractBackground: Because traditional nonsteroidal antiinflammatory drugs are 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. Data from randomized clinical trials prospectively addressing cardiovascular safety of acetaminophen, however, are still lacking, particularly in patients at increased cardiovascular risk. Hence, the aim of this study was to evaluate the safety of acetaminophen in patients with coronary artery disease. Methods and Results: The 33 patients with coronary artery disease included in this randomized, double-blind, placebo-controlled, crossover study received acetaminophen (1 g TID) on top of standard cardiovascular therapy for 2 weeks. Ambulatory blood pressure, heart rate, endothelium-dependent and-independent vasodilatation, platelet function, endothelial progenitor cells, markers of the renin-angiotensin system, inflammation, and oxidative stress were determined at baseline and after each treatment period. Treatment with acetaminophen resulted in a significant increase in mean systolic (from 122.4±11.9 to 125.3±12.0 mm Hg P=0.02 versus placebo) and diastolic (from 73.2±6.9 to 75.4±7.9 mm Hg P=0.02 versus placebo) ambulatory blood pressures. On the other hand, heart rate, endothelial function, early endothelial progenitor cells, and platelet function did not change. Conclusions: This study demonstrates for the first time that acetaminophen induces a significant increase in ambulatory blood pressure in patients with coronary artery disease. Thus, the use of acetaminophen should be evaluated as rigorously as traditional nonsteroidal antiinflammatory drugs and cyclooxygenase-2 inhibitors, particularly in patients at increased cardiovascular risk. Clinical Trial Registration: URL: http://www. clinicaltrials.gov. Unique identifier: NCT00534651. © 2010 American Heart Association. All rights reserved.
Persistent Identifierhttp://hdl.handle.net/10722/171413
ISSN
2015 Impact Factor: 17.047
2015 SCImago Journal Rankings: 7.853
ISI Accession Number ID
References

 

DC FieldValueLanguage
dc.contributor.authorSudano, Ien_US
dc.contributor.authorFlammer, AJen_US
dc.contributor.authorPériat, Den_US
dc.contributor.authorEnseleit, Fen_US
dc.contributor.authorHermann, Men_US
dc.contributor.authorWolfrum, Men_US
dc.contributor.authorHirt, Aen_US
dc.contributor.authorKaiser, Pen_US
dc.contributor.authorHurlimann, Den_US
dc.contributor.authorNeidhart, Men_US
dc.contributor.authorGay, Sen_US
dc.contributor.authorHolzmeister, Jen_US
dc.contributor.authorNussberger, Jen_US
dc.contributor.authorMocharla, Pen_US
dc.contributor.authorLandmesser, Uen_US
dc.contributor.authorHaile, SRen_US
dc.contributor.authorCorti, Ren_US
dc.contributor.authorVanhoutte, PMen_US
dc.contributor.authorLüscher, TFen_US
dc.contributor.authorNoll, Gen_US
dc.contributor.authorRuschitzka, Fen_US
dc.date.accessioned2012-10-30T06:14:00Z-
dc.date.available2012-10-30T06:14:00Z-
dc.date.issued2010en_US
dc.identifier.citationCirculation, 2010, v. 122 n. 18, p. 1789-1796en_US
dc.identifier.issn0009-7322en_US
dc.identifier.urihttp://hdl.handle.net/10722/171413-
dc.description.abstractBackground: Because traditional nonsteroidal antiinflammatory drugs are 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. Data from randomized clinical trials prospectively addressing cardiovascular safety of acetaminophen, however, are still lacking, particularly in patients at increased cardiovascular risk. Hence, the aim of this study was to evaluate the safety of acetaminophen in patients with coronary artery disease. Methods and Results: The 33 patients with coronary artery disease included in this randomized, double-blind, placebo-controlled, crossover study received acetaminophen (1 g TID) on top of standard cardiovascular therapy for 2 weeks. Ambulatory blood pressure, heart rate, endothelium-dependent and-independent vasodilatation, platelet function, endothelial progenitor cells, markers of the renin-angiotensin system, inflammation, and oxidative stress were determined at baseline and after each treatment period. Treatment with acetaminophen resulted in a significant increase in mean systolic (from 122.4±11.9 to 125.3±12.0 mm Hg P=0.02 versus placebo) and diastolic (from 73.2±6.9 to 75.4±7.9 mm Hg P=0.02 versus placebo) ambulatory blood pressures. On the other hand, heart rate, endothelial function, early endothelial progenitor cells, and platelet function did not change. Conclusions: This study demonstrates for the first time that acetaminophen induces a significant increase in ambulatory blood pressure in patients with coronary artery disease. Thus, the use of acetaminophen should be evaluated as rigorously as traditional nonsteroidal antiinflammatory drugs and cyclooxygenase-2 inhibitors, particularly in patients at increased cardiovascular risk. Clinical Trial Registration: URL: http://www. clinicaltrials.gov. Unique identifier: NCT00534651. © 2010 American Heart Association. All rights reserved.en_US
dc.languageengen_US
dc.publisherLippincott Williams & Wilkins. The Journal's web site is located at http://circ.ahajournals.orgen_US
dc.relation.ispartofCirculationen_US
dc.subject.meshAcetaminophen - Adverse Effects - Pharmacologyen_US
dc.subject.meshAgeden_US
dc.subject.meshAnti-Inflammatory Agents, Non-Steroidal - Adverse Effects - Pharmacologyen_US
dc.subject.meshBlood Pressure - Drug Effects - Physiologyen_US
dc.subject.meshCircadian Rhythm - Drug Effects - Physiologyen_US
dc.subject.meshCoronary Artery Disease - Physiopathologyen_US
dc.subject.meshCross-Over Studiesen_US
dc.subject.meshDose-Response Relationship, Drugen_US
dc.subject.meshDouble-Blind Methoden_US
dc.subject.meshEndothelium, Vascular - Drug Effects - Physiopathologyen_US
dc.subject.meshFemaleen_US
dc.subject.meshHeart Rate - Drug Effects - Physiologyen_US
dc.subject.meshHumansen_US
dc.subject.meshHypertension - Chemically Induced - Epidemiology - Physiopathologyen_US
dc.subject.meshMaleen_US
dc.subject.meshMiddle Ageden_US
dc.subject.meshPlatelet Adhesiveness - Drug Effects - Physiologyen_US
dc.subject.meshProspective Studiesen_US
dc.subject.meshRisk Factorsen_US
dc.subject.meshVasodilation - Drug Effects - Physiologyen_US
dc.titleAcetaminophen increases blood pressure in patients with coronary artery diseaseen_US
dc.typeArticleen_US
dc.identifier.emailVanhoutte, PM:vanhoutt@hku.hken_US
dc.identifier.authorityVanhoutte, PM=rp00238en_US
dc.description.naturelink_to_OA_fulltexten_US
dc.identifier.doi10.1161/CIRCULATIONAHA.110.956490en_US
dc.identifier.pmid20956208-
dc.identifier.scopuseid_2-s2.0-78349308026en_US
dc.identifier.hkuros183721-
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-78349308026&selection=ref&src=s&origin=recordpageen_US
dc.identifier.volume122en_US
dc.identifier.issue18en_US
dc.identifier.spage1789en_US
dc.identifier.epage1796en_US
dc.identifier.isiWOS:000283670800009-
dc.publisher.placeUnited Statesen_US
dc.identifier.f10008002956-
dc.identifier.scopusauthoridSudano, I=6602140497en_US
dc.identifier.scopusauthoridFlammer, AJ=13007159300en_US
dc.identifier.scopusauthoridPériat, D=24315258100en_US
dc.identifier.scopusauthoridEnseleit, F=6602935397en_US
dc.identifier.scopusauthoridHermann, M=7102188652en_US
dc.identifier.scopusauthoridWolfrum, M=8849452900en_US
dc.identifier.scopusauthoridHirt, A=24544719300en_US
dc.identifier.scopusauthoridKaiser, P=24544749600en_US
dc.identifier.scopusauthoridHurlimann, D=6602466831en_US
dc.identifier.scopusauthoridNeidhart, M=7003852942en_US
dc.identifier.scopusauthoridGay, S=8041777500en_US
dc.identifier.scopusauthoridHolzmeister, J=6603169763en_US
dc.identifier.scopusauthoridNussberger, J=7102690537en_US
dc.identifier.scopusauthoridMocharla, P=25922895000en_US
dc.identifier.scopusauthoridLandmesser, U=6602879397en_US
dc.identifier.scopusauthoridHaile, SR=35726499200en_US
dc.identifier.scopusauthoridCorti, R=7005136167en_US
dc.identifier.scopusauthoridVanhoutte, PM=7202304247en_US
dc.identifier.scopusauthoridLüscher, TF=18935805600en_US
dc.identifier.scopusauthoridNoll, G=7004483986en_US
dc.identifier.scopusauthoridRuschitzka, F=7003359126en_US
dc.identifier.citeulike9264318-

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