Too much Tylenol? Daily acetaminophen use may be bad for hypertension patients - Cardiovascular Business

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For patients in the acetaminophen group, the mean daytime systolic BP increased from 132.8 mm Hg to 136.5 mm Hg. In the placebo group, the mean systolic BP increased actually decreased from 133.9 mm Hg to 132.5 mm Hg. The mean daytime diastolic BP among patients in the acetaminophen group, meanwhile, increased from 81.2 mm Hg to 82.1 mm Hg. Patients from the placebo group again saw a slight decrease, with their mean daytime diastolic BP shifting from 81.7 to 80.9.

These findings, the team wrote, suggest that daily acetaminophen use is associated with BP increases that raise cardiovascular risk and give clinicians a reason to consider the safety of this common medication for certain high-risk patients.

MacIntyre and colleagues did point out that their study included “a relatively small sample size” and “very specific patient population.” However, they emphasized that these findings still present clinicians with some noteworthy data.

“The findings of our study further call into question current guidelines suggesting that acetaminophen is a safe alternative to nonsteroidal anti-inflammatory drugs (NSAIDs),” the authors wrote. “Indeed, the rise in BP seen in this study matches that seen with NSAIDs, and may well explain the finding that self-reported frequent acetaminophen use in women is associated with an increase in cardiovascular events similar to that seen with frequent NSAID use. While the precise mechanism of actions of acetaminophen remain unclear, it is believed to involve COX2 (cyclooxygenase-2) inhibition which may, at least in part, explain these similarities.”

The team also noted that caution should be recommended when considering prescribing the “regular use” of acetaminophen to patients with hypertension or who may otherwise already face a heightened risk of certain cardiovascular issues.