Long-term use of paracetamol raises blood pressure, says study

Researchers at the University of Edinburgh, published in the journal Circulation, suggest that paracetamol could further increase the risk of heart attacks and strokes in people with high blood pressure.

Paracetamol, also known as acetaminophen, is an analgesic (painkiller) medication used to treat fever and mild/moderate pain. It is a widely-prescribed, staple short-term remedy for fevers, aches, and pains. This is due to its inclusion in the WHO analgesic ladder, as well as decades of clinical experience.

The focus group had 110 volunteers in total, two-thirds of whom were either prescribed/self-medicating with paracetamol for hypertension (high blood pressure).

In a randomised trial, these volunteers were given 1g of paracetamol four times a day for two weeks— a standard dose for patients with chronic pain— after which they were given placebo pills for the next two weeks.

According to Professor James Dear, a clinical pharmacologist at Edinburgh, the trial showed that the paracetamol pills increased blood pressure, an important factor in heart attacks and strokes, much more than the placebo pills.

The BBC quoted the statements of Dr Dipender Gill, a clinical pharmacologist and therapeutics lecturer at St George's, University of London, according to whom the study had found "a small but meaningful increase in blood pressure in a white Scottish population". However, "many unknowns" remained.

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"Firstly, it is not clear whether the observed increase in blood pressure would be sustained with longer term use of paracetamol," and "secondly, it is not known for certain whether any increase in blood pressure attributable to paracetamol use would lead to an increased risk of cardiovascular disease."

However, the lead investigator, Dr Iain MacIntyre, a clinical pharmacology consultant at NHS Lothian, assured the public that the short-term use of paracetamol for headaches or fever was absolutely fine.

The researchers advise doctors to start patients with chronic pain on as low a dose of paracetamol as possible and keep a close eye on those with high blood pressure and at risk of heart disease.