7B.02

Abstract

Objective: Approximately 25% of hypertensive patients >65 years are treated for arthrosis, which is the most common cause of long term use of non-steroidal anti-inflammatory drugs (NSAID). NSAID inhibits prostaglandin synthesis and interacts with the renin angiotensin system. The objective of this study was to investigate if concomitant use of NSAID in hypertensive patients is associated with a lower possibility to reach target blood pressure <140/90 mm Hg, and to elucidate if there are gender differences regarding this matter.Design and method: This cross-sectional cohort study includes 40825 patients with hypertension from the Swedish primary Care Cardiovascular Database (SPCCD) in 2007–2008. Patient characteristics, antihypertensive drug class, dispensations of NSAIDs, comorbidities and blood pressure measurements were analyzed. The proportion of days covered (PDC) with prescription was calculated in order to analyze the NSAID use and the PDC was grouped <50%, 50–80% and >80% of days covered with prescription during 180 days prior to the last blood pressure measurement. Results: In all 6700 patients had at least one prescription of NSAID. Patients with NSAID were younger (67.9 ± 11.2 vs 69.4 ± 11.9 years, p < 0.0001), and more often female (63.2 vs 56.3%, p < 0.0001) with a diagnosis of musculoskeletal disease (20.8 vs 12.8%, p < 0.0001 and with no cardiovascular comorbidity (26.5 vs 32.1%, p < 0.0001). There was no difference in SBP between patients with and without NSAID (142 ± 16, 142 ± 17 mmHg respectively, ns). Patients with NSAID had a higher DBP (80 ± 10, 79 ± 10 mmHg, respectively p < 0.001). In a logistic regression model adjusted for age, smoking, cardiovascular comorbidity, antihypertensive drug class, education, and country of birth there was no difference in the proportion achieving target blood pressure in patients with and without concomitant use of NSAID irrespective of the PDC for NSAID users (figure 1). The results were similar in both genders. Conclusions: Concomitant use of NSAID in hypertensive patients does not seem to be associated with a higher blood pressure level. The use of NSAIDs is not associated with a reduced ability of achieving target blood pressure. Thus, hypertensive patients do not à priori need to be discouraged to use NSAID.