Meta-analysis: BP elevation with COX-2 inhibitors
A recently published meta-analysis associates cyclooxygenase-2 (COX-2) inhibitors with a point-estimate blood pressure (BP) elevation compared with placebo and nonselective nonsteroidal anti-inflammatory drugs (NSAIDs).
Researchers wanted to compare the magnitude of BP response between COX-2 inhibitors and nonselective NSAIDs. They performed a meta-analysis comparing the effects of COX-2 inhibitors with placebo, nonselective NSAIDs, and each other on BP elevation and hypertension. The analysis included BP data on 45,451 participants from 19 randomized, controlled trials.
Results of the meta-analysis of the trials showed a somewhat greater BP elevation with COX-2 inhibitors compared with placebo and nonselective NSAIDs. Rofecoxib (Vioxx) appeared to present a greater risk of developing hypertension and clinically important elevations in both systolic and diastolic BP compared with celecoxib (Celebrex). The effects observed might have most clinical significance in the elderly, in whom the prevalence of arthritis and hypertension is high, the researchers say.
Although COX-2 inhibitors are a welcome addition to the therapeutic options in the treatment of arthritis, their potential (and differential) effect on BP elevation requires caution in their use and warrants further investigation, the researchers conclude. "Clinicians need to weigh the risks of improved gastrointestinal safety versus potential hazards of developing elevated BP when considering the use of these agents, especially in the elderly population."
The results of this meta-analysis were published on the Archives of Internal Medicine on Feb. 14 and appeared in the March 14 print edition.
A recently published meta-analysis associates cyclooxygenase-2 (COX-2) inhibitors with a point-estimate blood pressure (BP) elevation compared with placebo and nonselective nonsteroidal anti-inflammatory drugs (NSAIDs).You have reached your article limit for the month. Subscribe now to access this article plus other member-only content.
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