Use of nonsteroidal anti-inflammatory drugs (NSAIDs) is on the rise (Open Heart, April 28, 2017). We’re talking about drugs like ibuprofen and naproxen. Such pain relievers are perceived as quite safe, since they have been available over the counter for decades. But there is growing evidence that prescription NSAIDs like celecoxib, diclofenac and meloxicam, as well as OTC ibuprofen and naproxen, can impact blood pressure. There are also concerns about heart attacks and other cardiovascular complications. Health care providers do not always warn patients about the blood pressure raising impact of NSAIDs. Some people are especially vulnerable as this person found out.
High Doses of Ibuprofen and High Blood Pressure!
Q. I was taking high doses of ibuprofen for spine and leg pain. My blood pressure was high, so my doctor prescribed BP medications. He added one after another without any obvious improvement. We were both feeling frustrated.
I finally tried going without ibuprofen, and my BP fell to normal. I started breaking my BP pills in half, and my BP stayed low, even under stressful conditions.
I strongly recommend that if you have stubbornly high blood pressure and take ibuprofen, stop it for a few weeks and check your BP.
You might have heard that the increased blood pressure due to using this type of pain reliever is no big deal. I am proof it can be impressive.
So, if you take a lot of ibuprofen and have high BP, don’t immediately take more BP meds. Instead, stop the pain reliever for a few weeks and check your numbers. I was shocked. You might be as well.
A. Thank you for sharing your story. Nonsteroidal anti-inflammatory drugs (NSAIDs) such as celecoxib, diclofenac, ibuprofen, naproxen and meloxicam can all raise blood pressure (BMC Cardiovascular Disorders, Oct. 24, 2012). Some people, like you, may be especially sensitive to this effect.
We don’t understand why more health professionals do not warn about this potential problem. And when it occurs, we’re puzzled why it is not considered as a contributing factor.
Up To Date Tells the Story!
We are big fans of Up To Date! This website strives:
“To help medical professionals make appropriate care decisions and drive better outcomes, UpToDate delivers evidence-based clinical decision support that is clear, actionable, and rich with real-world insights.”
Here is what Up To Date has to say about NSAIDs and hypertension:
“Nonsteroidal antiinflammatory drugs (NSAIDs) have a variety of adverse effects. From a cardiovascular viewpoint, they can both raise blood pressure and affect overall cardiovascular risk.”
EFFECT OF NSAIDS ON BLOOD PRESSURE
“All nonsteroidal antiinflammatory drugs (NSAIDs) in doses adequate to reduce inflammation and pain can increase blood pressure in both normotensive and hypertensive individuals.”
“In addition, NSAID use may reduce the effect of all antihypertensive drugs except calcium channel blockers.”
Ibuprofen and High Blood Pressure
In this case, the doctor prescribed a high dose of ibuprofen. The result was significant hypertension.
Q. Please warn people about overuse of ibuprofen. I have arthritis in my right knee. Climbing stairs is very painful
My doctor prescribed 1800 mg of ibuprofen daily. After taking it for several weeks, my BP rose to 190/106. My doctor told me to take Tylenol for the pain instead of ibuprofen. He also prescribed medication to lower my blood pressure.
A. A surprisingly large number of medications can raise blood pressure. High on the list are NSAIDs (nonsteroidal anti-inflammatory drugs) such as ibuprofen. Even OTC pills such as Advil, Aleve (naproxen) or Motrin IB could cause problems at high doses.
A study based on data collected as part of the National Health and Nutrition Examination Survey estimates that about 15 percent of American adults take a medication that could raise their blood pressure (JAMA Internal Medicine, Jan. 1, 2022). These include NSAIDs, antidepressants, corticosteroids and estrogen.
To learn more about such medications, as well as drugs to control hypertension and non-drug approaches, you may wish to review our eGuide to Blood Pressure Solutions. This online resource is available under the Health eGuides tab.
Another Ibuprofen and High Blood Pressure Story:
Q. My doctor prescribed 800 mg of ibuprofen a couple of times a day for the pain and inflammation of a severely twisted knee. When I took my blood pressure a few weeks later it was 180/96. That’s much higher than my usual 124/76.
That scared me, so I searched your website for answers. I discovered that ibuprofen and high blood pressure can go together. What else can I use for the pain?
Other Options for Pain:
A. Ask your doctor whether topical NSAIDs like diclofenac gel would help your pain without causing hypertension. There is research to suggest that when diclofenac is used as a spray, gel or patch, it is less likely to cause stomach upset or ulcers compared to the oral formulation (British Journal of Sports Medicine, May, 2018). That doesn’t mean it is safe, just a bit safer than pills.
You can learn more about the advantages of Voltaren Gel at this link.
Since you discovered that you are susceptible to ibuprofen and high blood pressure, you will need to be very especially careful. You will need to monitor your blood pressure even with a topical NSAID. We have heard from some readers who report good success, though.
E.B.M. gets her Voltaren Gel without a prescription when traveling:
“I have been buying Voltaren Gel in Germany and Mexico while traveling. It costs usually $10-15 overseas for a large tube. It has worked great for me and my friend who has rheumatoid arthritis and sometimes muscle spasms.
“I don’t use a lot since it is very easily spread (a thin gel). My blood pressure is normal. I would not be without it and was lucky to talk the nurse out of a sample one day.”
Not everyone can tolerate topical NSAIDs, though.
Marilyn developed a bad skin reaction with the prescription NSAID diclofenac:
“My doctor prescribed Voltaren Gel since pain meds upset my stomach. It didn’t upset my stomach, but on the fourth day of applying it, I broke out in a rash all over my arms and legs. I had to stop using it.”
Non-Drug Options for Controlling Pain:
Other options that should not raise your blood pressure include anti-inflammatory herbs such as ashwagandha, boswellia, ginger or turmeric. Bromelain derived from pineapple and Knox gelatin may also be beneficial.
You can learn more about them in our online resource, Alternatives for Arthritis. This eGuide is available for your computer or electronic device at this link. If you prefer a printed book you can hold in your hands, you can find it here.
Share your own story about NSAIDs below in the comment section. If you ever had problems with ibuprofen and high blood pressure please let us know. Learn more about controlling blood pressure at this link.