Long-term use of paracetamol linked with high blood pressure

Recent study led by scientists from CVS is the first large randomised clinical trial to address the long-term use of paracetamol in people with high blood pressure

The study published in the journal Circulation involved 110 patients with a history of high blood pressure who were prescribed one gram of paracetamol four times a day – a routinely prescribed dose in patients with chronic pain – or a matched placebo for two weeks. All patients received both treatments, with the order randomised and blinded.

Results showed that those prescribed paracetamol saw a significant increase in their blood pressure, compared with those taking the placebo.

The research team, which included Professor James Dear, Personal Chair of Clinical Pharmacology and Principal Investigator of the study Professor David Webb, suggests the findings should lead to a review of long-term paracetamol prescriptions to patients – particularly those with high blood pressure, or those at particular risk of heart disease or stroke.

This study clearly shows that paracetamol – the world’s most used drug – increases blood pressure, one of the most important risk factors for heart attacks and strokes. Doctors and patients together should consider the risks versus the benefits of long-term paracetamol prescription, especially in patients at risk of cardiovascular disease

Professor James Dear, Personal Chair of Clinical Pharmacology

We would recommend that clinicians start with a low dose of paracetamol, and increase the dose in stages, going no higher than needed to control pain. Given the substantial rises in blood pressure seen in some of our patients, there may be a benefit for clinicians to keep a closer eye on blood pressure in people with high blood pressure who newly start paracetamol for chronic pain

Professor David Webb, Chair of Therapeutics and Clinical Pharmacology

This study was funded by British Heart Foundation.

Professor David Webb

Professor James Dear

Hypertension and Renal research at CVS