Assessing the effects of non-steroidal anti-inflammatory drugs on antihypertensive drug therapy using post-marketing surveillance database

• Published in: Journal of epidemiology Vol. 18; no. 3; pp. 119 - 124
• Main Authors: Ishiguro, Chieko, Fujita, Toshiharu, Omori, Takashi, Fujii, Yosuke, Mayama, Takeshi, Sato, Tosiya
• Format: Journal Article
• Language: English
• Published: Japan Japan Epidemiological Association 2008
• Subjects: Aged; Angiotensin-Converting Enzyme Inhibitors - administration & dosage; Angiotensin-Converting Enzyme Inhibitors - pharmacology; Anti-Inflammatory Agents, Non-Steroidal - administration & dosage; Anti-Inflammatory Agents, Non-Steroidal - pharmacology; Antihypertensive Agents - administration & dosage; Antihypertensive Agents - antagonists & inhibitors; Arthritis - complications; Arthritis - drug therapy; Blood Pressure - drug effects; Calcium Channel Blockers - administration & dosage; Calcium Channel Blockers - pharmacology; Cohort Studies; Confidence Intervals; Databases, Factual; Diuretics - administration & dosage; Diuretics - antagonists & inhibitors; Drug Antagonism; Drug Therapy, Combination; Female; Humans; Hypertension - complications; Hypertension - drug therapy; Japan - epidemiology; Male; Middle Aged; Original; Product Surveillance, Postmarketing; Treatment Outcome; Japan
• ISSN: 0917-5040; 1349-9092
• DOI: 10.2188/jea.JE2007413

Antihypertensive and non-steroidal anti-inflammatory drugs (NSAIDs) are used to treat many common diseases. However, it has been suspected that interactions between these drugs exist. Here, we assessed the interactions between non-selective NSAIDs and several classes of antihypertensive drugs. The study design was a cohort study using "The Antihypertensive Drug Database," which is a collection of data accumulated from Drug Use Investigations. Subjects newly starting antihypertensive drug therapy were identified in the database. We compared the "User" group, who were co-administered NSAIDs, with the "Non-user" group, who were not. The outcome measure was the change in systolic blood pressure from the baseline after 2 months of treatment. We estimated the non-adjusted and adjusted differences in the change in systolic blood pressure between the "User" and "Non-user" groups. Data were collected for a total of 1,204 subjects, of whom 364 were prescribed beta blockers, 60 were prescribed diuretics, 628 were prescribed angiotensin-converting enzyme inhibitors, and 152 were prescribed calcium channel blockers. The adjusted difference in the change in systolic blood pressure between the User (n = 301) and Non-user (n = 903) groups was 2.88 mmHg (95% confidence interval: 0.89, 4.87); thus, systolic blood pressure in the Non-User group decreased further from the baseline than that in the User group. In subjects administered beta blockers, diuretics, angiotensin-converting enzyme inhibitors, and calcium channel blockers, the corresponding differences were 0.37 mmHg (-3.24, 3.98), 6.11 mmHg (-3.16, 15.37), 3.85 mmHg (1.16, 6.66), and 3.50 mmHg (-2.03, 9.02). The effectiveness of antihypertensive drugs was attenuated by the co-administration of NSAIDs. The differences in the effects of NSAIDs varied with different classes of antihypertensive drugs.