Study: Doctors Should Carefully Select Arthritis Drugs for Hypertensives

An estimated 30 million Americans over the age of 35 have arthritis, and 12 million of those take antihypertensive drugs.

Nonsteroidal anti-inflammatory drugs and COX-2 selective inhibitors are the most widely used arthritis medications and are well known to increase systolic blood pressure, particularly in patients who are already hypertensive.

A new study reported in the April issue of Rheumatology suggest that physicians should be careful in selecting arthritis medications for hypertensive patients to prevent further increases in their blood pressure and risk of cardiovascular events.

Led by Dr. Gurkirpal Singh, of Stanford University School of Medicine, the researchers investigated the impact of increased blood pressure levels in arthritis patients caused by the medications that their physicians prescribe.

The researchers also found that even small increases in systolic blood pressure can have startling effects on the rates of ischemic heart disease and stroke in patients with both arthritis and hypertension.

"It is impotant that clinicians who treat patients with osteoarthritis or rheumatoid arthritis accurately weigh the potential risks of these medications against their benefits," concluded the researchers.

In an accompanying editorial, Dr. Richard Day, a rheumatologist at the University of New South Wales in Australia, said it is reasonable for physicians to take the researchers' suggestion seriously.

"It also follows that we will need to be more vigilant in monitoring our patients' blood pressures and more careful in the selection and review of the medicines we and others prescribe," he added.

Other sources: Journal of Rheumatology 2003;30:714-9