Blood pressure warning over long-term paracetamol use

A study by the University of Edinburgh has issued a warning over the long-term use of paracetamol, saying that their research found that it increased blood pressure raising the risks of heart attack and stroke.
The researchers say that doctors need to rethink the long term usage of the drug balancing the risks with the benefits, stressing at the same time that the drug is safe for short term use with fevers and headaches.
Scientists have called for more long term research with a larger number of patients in order to confirm the findings and to clarify the risk levels.
Used widely around the world to deal with headaches, fevers and short term aches and pains, is also prescribed at time to manage long term pain despite their being little evidence of the benefit.
One out of every three people in the UK is affected by high blood pressure with as many as one in ten being prescribed paracetamol.
The University of Edinburgh randomised trial tracked 110 volunteers, two-thirds of whom were taking drugs for high blood pressure, or hypertension.
Each volunteer was asked to take 1g of paracetamol four times a day for two weeks, a common dose for patients with chronic pain, and then dummy pills, or placebo, for another two weeks.
Clinical Pharmacologist Prof James Dear said: “The trial showed paracetamol increased blood pressure, one of the most important risk factors for heart attacks and strokes.” He continued saying that the rise in blood pressure was much more than a placebo.
As a result the researchers have advised doctors to start patients with chronic pain on as low a dose of paracetamol as possible and to keep a close eye on those with high blood pressure and at risk of heart disease.
Dr Benjamin Ellis, Consultant Rheumatologist at Versus Arthritis said: “If you are concerned about the risks from pain medicines you should speak with a healthcare professional to explore your options.” Lead investigator Dr Iain MacIntyre, Clinical Pharmacology Consultant, at NHS Lothian, said: “This is not about short-term use of paracetamol for headaches or fever, which is, of course, fine.”

Many unknowns about paracetamol use

Dr Dipender Gill, Clinical Pharmacology and Therapeutics Lecturer, at St George’s, University of London, said the study, published in the journal Circulation, had found “a small but meaningful increase in blood pressure in a white Scottish population” but “many unknowns remain”.
“Firstly, it is not clear whether the observed increase in blood pressure would be sustained with longer term use of paracetamol,” he said.
“Secondly, it is not known for certain whether any increase in blood pressure attributable to paracetamol use would lead to an increased risk of cardiovascular disease.”
Links have been found before by a  large US study previously but it could not prove one caused the other, with other smaller studies unable to confirm the link.
The Edinburgh team said they could not explain how paracetamol would raise blood pressure but their findings should lead to a review of long-term paracetamol prescriptions, previously considered safer than non-steroidal anti-inflammatory painkillers, such as ibuprofen. The latter are thought to raise blood pressure in some people.
The British Heart Foundation, which funded the study, said doctors and patients should regularly rethink whether any medication, even something “relatively harmless like paracetamol”, was needed.
Dr Richard Francis, from the Stroke Association, said further research in people with normal, healthy blood pressure, over a longer timeframe, was needed “to confirm the risks and benefits of using paracetamol more widely”.

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