Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2013 Jun;75(6):1396-405.
doi: 10.1111/bcp.12032.

A systematic review of the effect of paracetamol on blood pressure in hypertensive and non-hypertensive subjects

Emma J Turtle  1 , James W Dear, David J Webb
Affiliations

A systematic review of the effect of paracetamol on blood pressure in hypertensive and non-hypertensive subjects

Emma J Turtle et al. Br J Clin Pharmacol. 2013 Jun.

Abstract

Aim: To review current evidence on the effect of paracetamol on blood pressure (BP), the quality of the previous studies and the validity of the results, and to summarize these findings.

Methods: A systematic literature review was performed by searching PubMed, the Cochrane library and EMBASE for publications between the years 1963 and 2012.

Results: We identified three case reports, seven prospective observational trials, six randomized controlled trials, one commentary and two reviews. Some, but not all, of the observational studies, which included over 147 000 patients, showed an increased risk of hypertension with paracetamol use. The randomized studies were generally small and the results were inconsistent. Three studies, which included 104 patients, showed an increase of systolic BP by ~4 mmHg, two studies, which included 27 patients, reported no change in BP and one study, which included 21 patients, reported a fall in BP although no placebo arm was included for comparison.

Conclusions: The overall effect of paracetamol on BP is unclear. Given that paracetamol is often suggested as a safer alternative to non-steroidal anti-inflammatory drugs (NSAIDs), it would seem that further prospective evidence is now needed to address the effect of paracetamol on BP. This would be best done with larger studies in relevant cohorts using BP measured by ambulatory BP monitoring as the primary endpoint.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Potential biological mechanisms underlying the BP raising effect of paracetamol
See this image and copyright information in PMC

References

    1. Sheen CL, Dillon JF, Bateman DN, Simpson KJ, MacDonald TM. Paracetamol toxicity: epidemiology, prevention and costs to the health-care system. Q J Med. 2002;95:609–619. - PubMed
    1. Aronoff DM, Oates JA, Boutaud O. New insights into the mechanism of action of acetaminophen: its clinical pharmacologic characteristics reflect its inhibition of the two prostaglandin H2 synthases. Clin Pharmacol Ther. 2006;79:9–19. - PubMed
    1. Hao CM, Breyer MD. Physiological regulation of prostaglandins in the kidney. Annu Rev Physiol. 2008;70:357–377. - PubMed
    1. Antman EM, DeMets D, Loscalzo J. Cyclooxygenase inhibition and cardiovascular risk. Circulation. 2005;112:759–770. - PubMed
    1. Mburu DN, Mbugua SW, Skoglund L, Lokken L. Effects of paracetamol and acetylsalicylic acid on the post-operative course after experimental orthopaedic surgery in dogs. J Vet Pharmacol Ther. 1998;11:163–171. - PubMed

Publication types

MeSH terms