When you have a headache or a sore back, it’s natural to reach for the closest bottle of over-the-counter (OTC) pain reliever you have handy. You may have done your research to learn the difference between acetaminophen and ibuprofen and know which one to go for based on your type of pain, but do you consider your blood pressure before you take a few of the pills? Some say that OTC pain relievers are bad for blood pressure, while others swear they’re okay.
Let us know what you think. If you have hypertension, should you stay away from the meds, or are you in the clear? After you vote, keep reading to see what science says on the matter.
Taking Pain Relievers with High Blood Pressure
There are certainly pain relievers that can have a detrimental effect on blood pressure, but there are also medications that are safer to take. People with high blood pressure get headaches too, and no one expects them to go untreated.
Doctors recognize this and work to develop plans with patients to best address pain. Medical researchers conduct endless studies on the topic, publishing results that provide guidance. We’ll discuss a few of these studies further below.
You can find brand-name and generic versions of pain relievers that pharmaceutical companies develop specifically with blood pressure in mind. Additionally, a doctor may advise that it is safe to take an over-the-counter pain medication even if you do have high blood pressure. Always make sure to ask your treating physician for their advice and what medication they recommend.
If you are healthy, with no history of hypertension or cardiovascular issues, there is no reason for concern in regard to over-the-counter medication. Many physicians recommend them before trying prescription pain killers such as opioids, and they are proven to be effective at treating mild to moderate pain with no risk of addiction.
An Introduction to Pain Relievers
Most OTC pain relievers are a type of medication known as non-steroidal anti-inflammatory drugs (NSAIDs). These include ibuprofen, aspirin, and naproxen sodium. They go by many brand-names, but all the medications work the same as their generic counterparts, and all are NSAIDs. The exception to this common type of drug is acetaminophen. The FDA classifies acetaminophen as a general analgesic.
NSAIDs reduce pain, help lower fevers, and prevent blood clots. For those who suspect they are having a heart attack, experts recommend chewing an aspirin due to its ability to thin the blood. They also help reduce inflammation throughout the body.
These pain relievers work by blocking endocannabinoid reuptake in the brain, as well as suppressing COX-2, an enzyme in the body that can increase levels of inflammation.
The Effect on Blood Pressure
While NSAIDs have blood-thinning properties, studies show that they may still have adverse effects in hypertensive patients. The study states that ibuprofen has the most notable effect; those other NSAIDs are not far behind. Those who use the pain relievers are shown to have higher systolic blood pressure compared to individuals who take acetaminophen.
Additionally, further studies state that NSAIDs may inhibit the efficacy of medications that treat hypertension and that patients should take caution. If you have high blood pressure or a heart condition, seek the advice of your doctor before taking an NSAID medication.
According to Niece Goldberg, MD, of the American Heart Association, NSAIDs can potentially reduce blood flow to the kidneys, decrease the efficacy of diuretic medications, and therefore increase blood pressure.
The Case for Aspirin
But why would experts recommend a patient take aspirin if they suspect they are having a heart attack if NSAIDs are bad for blood pressure? Research shows that aspirin may protect against heart attacks. Furthermore, it shows far fewer interactions with medications that treat hypertension.
Patients taking aspirin to prevent cardiovascular events, however, should take low-dose forms of the medication. The main case for aspirin is that it works as a blood thinner, potentially allowing more blood to flow to the heart during a cardiovascular event. The most important factor in the study shows that aspirin is most effective at preventing cardiovascular events only when individuals take it before bedtime.
Acetaminophen works differently than NSAID medications. Researchers are not sure precisely how it works in the brain and central nervous system, though they believe that it may interfere with the neurotransmission of pain-inducers between the brain and spinal cord and may also inhibit COX-2 in a way similar to NSAIDs. However, acetaminophen possesses no anti-inflammatory properties.
Drug manufacturers often combine acetaminophen, which is an over-the-counter medication, with prescription drugs such as oxycodone or morphine. Additionally, it can be combined with NSAIDs, particularly in headache relief medications.
The Effect on Blood Pressure
One study shows that patients taking acetaminophen do show an increase in blood pressure, though the increase is not permanent. When patients stop taking the medication, blood pressure returns to normal. However, this study looks at only healthy individuals with no history of hypertension or heart disease.
Another study documents that in those who do have a history of hypertension, the results may not be as promising. The study suggests that in patients with coronary artery disease, a single dose of the medication can cause a significant spike in blood pressure, but the spike is still temporary. Researchers urge patients and doctors to thoroughly evaluate the risks of taking such medication if a pre-existing condition exists.
Goldberg, however, does recommend that those with heart conditions try acetaminophen and aspirin for pain relief before turning to alternate NSAID medications. Medical professionals concur that acetaminophen is the safest over-the-counter pain reliever to take if you have concerns about blood pressure.
The Bottom Line on Pain Relievers and Blood Pressure
According to multiple studies, both NSAID medications and acetaminophen may increase blood pressure. Aspirin, when taken at night, can have a positive effect on lowering blood pressure in pre-hypertensive patients.
So, what’s a person to do? Generally, pain relievers are safe for those without pre-existing health conditions. However you should not take them for a prolonged period. If you experience pain that is chronic or long-lasting, contact your medical provider.
If you are looking for how to choose the safest over-the-counter pain medications, you must know the ingredients in the medication you choose. Understand their potential interactions with other medications you are currently taking, and take into account various lifestyle factors such as your average alcohol consumption.
For Those with Pre-Existing Conditions
For individuals with pre-existing conditions, you must consult your doctor before taking any pain reliever; NSAIDs, acetaminophen, or otherwise. This includes diabetics, those with heart conditions, and auto-immune disorders. Only a medical professional can advise you on the proper course of treatment.
Those Taking Other Medications
Additionally, anyone currently taking other medications should consult with a doctor regarding the most appropriate pain reliever. As both NSAIDs and acetaminophen can interact with prescription or other over-the-counter drugs, you must have clear direction from a medical professional on which is the safest route to take.
Acetaminophen is known to have far fewer drug interactions than other over-the-counter pain relievers.
Natural Pain Remedies
With many concerns over medication interactions, more patients are turning to holistic treatment options to treat pain. From avoiding foods that make the pain worse to trying stretching exercises that eases back pain, there are many options to try before turning to pain relieving medications. However, even before starting a holistic treatment regimen, it is essential to consult with your treating physician.