August 17, 2005

Aleve (Bayer), Advil (Wyeth), Motrin (McNeil-PPC):

Watch painkiller intake, doctors advise

Women taking daily amounts of non-ASA painkillers, such as extra-strength Tylenol, should monitor their blood pressure, doctors say after a new study suggesting a link between the drugs and hypertension.

"If you're taking these over-the-counter medications at high dosages on a regular basis, make sure that you report it to your doctor and you're checking your blood pressure," said Christie Ballantyne, a cardiologist at Houston's Methodist DeBakey Heart Center who had no role in the study.

While many popular over-the-counter painkillers have been linked before to high blood pressure, acetaminophen, sold as Tylenol, has generally been considered relatively free of such risk.

It is the only one that is not a non-steroidal anti-inflammatory drug, or NSAID, a class of medications that include ibuprofen (sold as Advil and Motrin) and naproxen (sold as Aleve). However, the new study found that women taking Tylenol were about twice as likely to develop blood-pressure problems. Risk also rose for women taking NSAIDS other than ASA.

The research found ASA remains the safest medicine for pain relief. It has long been known to reduce the risk of cardiovascular problems and was not included in the government's requirement for stricter labels for NSAIDS.

The study involved 5,123 women participating in the Nurses' Health Study at Harvard Medical School and Brigham and Women's Hospital in Boston. None had had high blood pressure when the study -- published in the American Heart Association journal Hypertension -- began.

"It certainly sets the basis for more studies," said Stephanie Lawhorn, a cardiologist at St. Luke's Mid America Heart Institute in Kansas City. "Most of the time we think that things like acetaminophen are fairly safe drugs."
The study found women aged 34 to 77 who took an average daily dose of more than 500 milligrams of acetaminophen (equivalent to one extra-strength Tylenol) had about double the risk of developing high blood pressure within about three years. For women 51 to 77 who took more than 400 milligrams a day of NSAIDS (equal to two ibuprofen), their risk of developing high blood pressure increased by 78 per cent over those who did not take the drug. Those 34 to 53 had a 60-per-cent risk increase.

"By pointing out risks associated with these drugs, more informed choices can be made by women and their clinicians," lead author John Phillip Forman, of Harvard Medical School, said in an e-mail.Previous research linking these drugs to blood-pressure problems did not look at dosages.