Effects of non-steroidal anti-inflammatory drugs on hypertension control using angiotensin converting enzyme inhibitors and thiazide diuretics.

OBJECTIVES

To determine the impact of three non-steroidal anti-inflammatory drugs on the efficacy of two anti-hypertensive drugs.

DESIGN

Fifteen women with arthritis and hypertension who were receiving lisinopril and HCT, and administered sequentially in random order ibuprofen, sulindac, and diclofenac for one month each, with an intervening two-week washout period between each treatment period. During the washout period, subjects received paracetamol.

SETTING

Hypertension Clinic, Medical Centre, Harare, Zimbabwe.

SUBJECTS

Fifteen female hypertensive women with documented arthritis.

MAIN OUTCOME MEASURES

Blood pressure at the end of two weeks of paracetamol was compared with blood pressure after one month of treatment with each of the NSAID.

RESULTS

Mean blood pressure was unchanged before and after all NSAIDs: 108 +/- 7 versus 107 +/- 9 for diclofenac, 108 +/- 9 versus 108 +/- 9 for sulindac, and 108 +/- 8 versus 107 +/- 9 for ibuprofen. The 24 hour urinary sodium excretion was not significantly different.

CONCLUSION

The three NSAIDs investigated did not neutralise the antihypertensive effect of the combination of lisinopril and HCT, and hence the blood pressure lowering action of the combination may not be prostaglandin dependent.