June 1, 2023

Coming up on today’s episode for years it’s been well-established that chronic use of nsaids will increase the blood pressure of patients this can cause a variety of problems in patients especially those with hypertension this can put the population at risk for some very serious side effects such as m eyes for them it’s been the general consensus for years to treat

Their chronic pain with the common analgesic tylenol however new studies have shown that tylenol can increase the blood pressure of patients as well today the pharmacists will be discussing this matter it’s tylenol really a better option for chronic pain or a fast-track to the emergency hello and welcome to the pharmacist today we have a fun-filled show for you

As it is pharmacist awareness month so we’d like to take this time just to discuss with you guys the different things that your pharmacists can do for you we would also like to discuss some of the different viewer questions that we’ve gotten this week let’s start the show with a video question submitted by paige from elbow saskatchewan i recently watched dr. oz

Though and there was an article published that said tylenol can do this too is that true and if it is what should i take thanks is an excellent question paige so we pulled up the article here so that our viewers at home can see this article as well we use pubmed which is a great and reliable source for articles such as this one it is also very user friendly you

Can type in a few words we use blood pressure and acetaminophen and just hit search the link to the article is on our website as well yeah so well the information that we gather is very important it’s also very important that we pay attention to the manner in which the information was compiled together and the way that the study was conducted so we’d like to take

A few minutes just to discuss with you guys some of the different questions that we use when we critically appraise an article for the show the very first thing we look at is the who what and how this study looked at 33 patients with well controlled coronary artery disease the patients were selected from hospital in switzerland and they were mainly men between

The ages of 18 to 80 the primary outcome that the researchers were looking at was to measure blood pressure and relationship to acetaminophen use this was across a risk study where the intervention who was a 1 gram tablet of acetaminophen taken three times a day for two weeks the control was a placebo pill taken in the same manner for two weeks as well and in

Between the intervention and the placebo phase we had a washout phase for two weeks as well mm-hmm so the second thing that we always want to make sure that we look at is the different things that tell us whether or not this article can be trusted so these are things called the threats to internal validity so we have confounding biased and chance so in the study

The researchers did do a couple different things just to lower those three factors so we’ll start with confounding so in the study the researchers looked at some different secondary factors on the elect at platelet function and sumreen an angiotensin system markers to be able to tell whether or not the response that they got from their intervention was actually

Due to the acetaminophen or whether or not it was due to some other confounding factors they also used randomization however because they didn’t provide a baseline characteristics table we were unsure of whether or not this randomization was successful so now we look at bias these researchers tried to eliminate bias by blinding both the researchers as well as

Their participants first bias that we did see was selection bias and we saw this as all of the participants were taken from the exact same hospital the second bias that we saw was confirmation bias as they stopped looking for the secondary outcomes after 22 of their 33 patients we were also concerned about the threats to chance because not all patients in the

Study necessarily needed acetaminophen the researchers could only use the minimum amount of patients needed in order to get statistically significant results this number had to be determined before the study started however it seems that they chose the number somewhere in the middle of the study this study started off with 22 patients and then a sample size was

Then increased to 33 patients mm-hmm so there were some different threats to validity in this specific study so we can’t make include a conclusion just yet about this article we still need to look at the results so in this case the results showed an increase in both the systolic and diastolic blood pressure when acetaminophen was used the same increase was not

Seen in the placebo statistical significance in this study was seen at a p-value of less than 0.05 and so the p-value for the systolic blood pressure was 0.02 1 and the p-value for diastolic blood pressure was 0.02 for both of these are statistically significant and worth noting so our statistics are very important however we also need to make sure that we look

At one final thing which is whether or not these results are generalizable to other patient populations so the patients were subjected to very strict inclusion and exclusion criteria they started off with a very large volunteer population and then through the process they really limited it down to only 33 patients and in addition this study did not include very

Many females so we cannot confidently say that these results would be applicable to the general female population and as well inclusion criteria only included well controlled coronary artery disease it excluded uncontrolled coronary artery disease cardiovascular and non cardiovascular conditions therefore we conclude that these results from this study cannot be

Generalized to patient populations so page to answer your question this study does show an increase in blood pressure due to the use of acetaminophen that being said as we’ve discussed in the last few minutes these results are not necessarily as they initially seem to be the current guidelines are still to use acetaminophen for pain management most experts will

Still agree that for high blood pressure acetaminophen is still the safest option to use correct yeah so we want to make sure that those of you who have hypertension are making sure that you’re not using non-steroidal anti-inflammatory drugs so that’s drugs like your advil or your naproxen these drugs have significant effects on the cardiovascular system in order

For these guidelines to change there is gonna have to be many more different studies done looking at acetaminophen use as well as a more generalized patient population although if you are using tylenol frequently to control pain it is always a good idea to go visit your doctor and see if this is still the best option for you and again it’s always great to keep a

Track of your blood pressure in between physician visits just to know how well your condition is being controlled and if you don’t have a blood pressure machine at home your local pharmacy will so be sure to check that out coming up after the break we have all the new services that your local pharmacies will be providing for you within this month see you after the break

Transcribed from video
Can Acetaminophen Increase Blood Pressure? By Mike Muller