boxes of Advil (ibuprofen) 200 mg

People in pain are caught in a terrible bind. When you hurt, it is common for your blood pressure to go up. That’s hardly a surprise. Pain is extremely stressful for your entire body. But taking nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen or naproxen can also boost your blood pressure. That’s the finding of a study presented at the European Society of Cardiology 2017 Congress in Barcelona, Spain.

PRECISION-ABPM Tells the Tale:

Researchers love acronyms. Here is what this study stands for:

Prospective Randomized Evaluation of Celecoxib Integrated Safety versus

Ibuprofen Or Naproxen Ambulatory Blood Pressure Measurement Trial

That’s a mouthful! What it boils down to is that Dr. Steve Nissen of the Cleveland Clinic and his colleagues compared celecoxib (Celebrex) with ibuprofen and naproxen. They were specifically looking for changes in blood pressure. Keep in mind that there was no placebo group, so we do n0t know how these patients would have responded had a control group been given sugar pills.

At the end of four months, ibuprofen performed worst. That is, it raised blood pressure the most. Naproxen came in second. Both drugs raised BP more than celecoxib. What really concerned us was the discovery that at the end of four months quite a few people were newly diagnosed with hypertension. Keep in mind that these folks had normal blood pressure at the start of the trial.

New-Onset Hypertension:

  • 35% were newly diagnosed in the ibuprofen group
  • 27% were newly diagnosed in the naproxen group
  • 15% were newly diagnosed in the celecoxib group

We find these numbers shocking. What it means is that many people will be pushed over the edge into hypertension because of their pain pills.

Putting NSAIDs into Perspective:

Are you ready for some surprising stats? Roughly one out of five Americans use an NSAID on a regular basis. It is estimated that over 40% of people with arthritis have high blood pressure. Many of these folks rely on NSAIDs for relief from stiff, aching joints.

What about you? Do you take ibuprofen, naproxen or some other NSAID? Although the PRECISION-ABPM trial relied on prescription-strength doses of NSAIDs, we suspect that some older people may be sensitive to lower doses of these drugs as well. Kidney function is reduced with age. That makes older people more susceptible to both hypertension and kidney damage. Could an NSAID boost your blood pressure?

Are There Alternatives to NSAIDs?

Perhaps the only way to tell if ibuprofen or a related NSAID (diclofenac, meloxicam, naproxen, etc) might boost your blood pressure would be a drug holiday. Stopping an NSAID for several days or weeks might bring blood pressure back down to normal or at least lower hypertension.

On the other hand, going without pain meds for several weeks may not be acceptable for many people in chronic pain. That is why we have written Graedons’ Guide to Alternatives for Arthritis. It describes anti-inflammatory herbs and spices such as turmeric (curcumin), ginger, bromelain, Ashwagandha, boswellia and stinging nettle. Then there are home remedies like Certo and grape juice or gelatin. You can learn more about these approaches at this link.

Cardiologists are beginning to realize the dangers of NSAIDs, especially for older people with heart problems. Perhaps it’s time for everyone with high blood pressure to realize that NSAIDs in general and ibuprofen in particular may be making things worse. Keep in mind that the PRECISION-ABPM trial did not have a control group. How much worse would the NSAIDs have performed if they were compared to placebo? We will never know the answer to that question.

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  1. Peggy

    Got my finger caught in the ladder and of course it started to swell as it was right there at the cuticle. As it throbbed I continue to do what I was doing and an hour later went in and fix some cottage cheese with a seasoning of turmeric, black pepper, and garlic powder. Within a couple of hours I realized that my finger was not swelling anymore and did not hurt. I was concerned I would have to take a needle and puncture my nail but I did not have to and it has only been two days. All I have to show for this accident is black at the top of the nail no pain no swelling.

  2. Betty
    S. C.

    I have CLL, am 85, have had it for 26 years. My husband 86, has three stints in his heat, has had them for thirteen years. He asked his doctor what was the safest pain killer and he said Alieve, is thIs true because once in a while I need something to ease a pain.

  3. Tom M

    For sure, NSAID’s have bumped up my pressure. I recently had a tooth refilled and it has been giving me some throbbing pain at times. I tried a few Advils and they made me feel different. My blood pressure spiked up about 40 points. I tried some Tylenol, and it wasn’t nearly as bad. I do not like taking anything for pain like these pills and rarely use them. I think they are definitely long term poisons.

  4. Barbara
    Albany, NY

    No control group and the fact that blood pressure rises normally when you’re in pain. Sounds to me like this particular study was pretty much useless. That being said, ‘rumor’ has it that NSAIDS do elevate blood pressure but not horrendously.

    OK, so now what? When you’re in pain, it’s a stressor and causes high blood pressure. The alternatives may or may not work. Herbals work fine when they work, but often they are not enough to conquer a high level of pain and what works for one person may not work for another.

    However, one thing that I have had extreme good luck with is Boron. I take Triple Boron Complex, which includes every kind of boron. I take at least six mgs per day and now VERY LITTLE PAIN! I’ve tried many of the herbal remedies with no success but Boron works well. It’s cheap, easily obtainable and, in my case, works wonderfully. Now my NSAID use is minimal. Some days, I don’t take NSAIDS at all and I have a goodly amount of arthritis and left-over shingles pain.

  5. Trace

    My doctor finally took me off Aleve for pain and now I take Nortriptyline 50mg @bed time. It hasent really helped with the pain but, helps me sleep. The reason for the pain was the Atorvastatin 40mg I was given after my stroke in Feb. Two weeks later my whole body ached, now six monthes later I still have aches through my body but, mostly in my legs. I quite taking it the atorvastatin. Has anybody experienced negative results while taking Nortriptyline? Thanks for any feed back.

  6. Rick

    Blood pressure is increased with the use of any NSAID for a rather simple reason these drugs are toxic and they attack the mitochondria which causes cellular stress. Any of the medications that use propanoic acid as a base actually trigger your own endorphins and by doing so modify pain responses!

  7. Bonnie
    Naperville, IL

    I can attest to the dangers of too much use of a drug like Advil (which is great at controlling pain, however). I have arthritis in my right knee, and sometimes would have to drag the leg up the stairs. I have a good tolerance for paid meds, but began taking 1800 mg of Advil per day. That’s 9 pills in an 18-hour period. Eventually, I became dizzy & unsteady – went to my doctor and the BP was 188/108. He told me to take Tylenol instead and prescribed BP meds for me. I learned that Advil has a ton of sodium in it, & with the daily quantity I was taking, the salt intake spiked the BP to an almost stroke level. I got a cortisone injection in the knee last spring & am scheduled for a second this fall. The pain has reduced by at least 80%.

  8. Mike

    Do we know whether low-dose aspirin also raises blood pressure?

    Also, wen you first talked about low-dose aspirin, maybe 30 years ago, you talked about 30mg/day. How did the standard become 81mg? Would there be the same benefit – and less blood pressure risk – from taking half a 8mg pill each day?

  9. Sharyn

    I was prescribed Flector patches for a neuropathy in the groin area. After just two days, my blood pressure had gone from normal to 200/100. I called the doctor’s office and was told that it was unlikely the patches were the cause as that was a rare side effect. I stopped using them and blood pressure returned to normal in two days.

    • Carol

      I would love to know what it is in doctor’s training that they are convinced that if a side effect is rare, it means it never happens, if it’s uncommon that also means it never happens, if it’s common that means it rarely happens. I’ve had several experiences with drugs over the years that had a clear correlation with side effects, and so has my husband, and in each case, the doctors said there was no connection (Rolling my eyes.)

      I remember saying to my doctor that I thought Levaquin was causing problems with my ankle and foot tendons. Absolutely no connection from her point of view. Later that same year, the FDA announced that there definitely was a connection. The list goes on. It’s quite detrimental to their patients, and I don’t know why they do it.

      No, I don’t believe that it has anything to do with money in the case of our doctors. I think it’s how they’ve been taught to think.

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