Effect of non-steroidal anti-inflammatory drugs on control of hypertension by beta-blockers and diuretics

Lancet. 1986 May 3;1(8488):997-1001. doi: 10.1016/s0140-6736(86)91271-7.

Abstract

The effect of sulindac on renal function and blood pressure was compared with those of placebo, piroxicam, and naproxen in 20 patients with primary hypertension being treated with a diuretic and a beta-blocker. Although the three non-steroidal anti-inflammatory drugs (NSAIDs) did not differ in their effect on renal function (weight, glomerular filtration rate, creatinine clearance) or on serum thromboxane and plasma 6-keto prostaglandin F1 alpha (6-keto PGF1 alpha), blood pressure was significantly lower with sulindac than with placebo, piroxicam, or naproxen. These differences were associated with less renal cyclooxygenase inhibition by sulindac (reflected by urinary thromboxane B2 and 6-keto PGF1 alpha) than by other NSAIDs. The findings suggest that the blood pressure differences reflect vasodilation due to differences in the balance between systemic and renal effects of the NSAIDs.

Publication types

  • Clinical Trial
  • Comparative Study
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • 6-Ketoprostaglandin F1 alpha / urine
  • Adrenergic beta-Antagonists / therapeutic use*
  • Adult
  • Amiloride / administration & dosage
  • Anti-Inflammatory Agents / pharmacology*
  • Anti-Inflammatory Agents, Non-Steroidal / metabolism
  • Anti-Inflammatory Agents, Non-Steroidal / pharmacology
  • Blood Pressure / drug effects
  • Clinical Trials as Topic
  • Diuretics / therapeutic use*
  • Double-Blind Method
  • Drug Synergism
  • Drug Therapy, Combination
  • Female
  • Humans
  • Hydrochlorothiazide / administration & dosage
  • Hypertension / drug therapy*
  • Indenes / pharmacology*
  • Male
  • Middle Aged
  • Naproxen / pharmacology
  • Piroxicam
  • Random Allocation
  • Sulindac / metabolism
  • Sulindac / pharmacology*
  • Thiazines / pharmacology
  • Thromboxane A2 / urine
  • Timolol / therapeutic use

Substances

  • Adrenergic beta-Antagonists
  • Anti-Inflammatory Agents
  • Anti-Inflammatory Agents, Non-Steroidal
  • Diuretics
  • Indenes
  • Thiazines
  • Hydrochlorothiazide
  • Piroxicam
  • Sulindac
  • Thromboxane A2
  • Naproxen
  • 6-Ketoprostaglandin F1 alpha
  • Amiloride
  • Timolol