From the Guidelines
Naproxen does not significantly increase blood pressure in most individuals, according to the most recent and highest quality study available 1. However, it's essential to consider the potential effects of naproxen on blood pressure, especially in people with pre-existing hypertension or cardiovascular risk factors. The mechanism by which naproxen and other NSAIDs may affect blood pressure involves the inhibition of prostaglandin synthesis, leading to sodium and water retention and increased vascular resistance. Some key points to consider:
- The risk of blood pressure elevation with naproxen use may be more pronounced in individuals with existing hypertension, heart failure, kidney disease, or those taking certain blood pressure medications.
- Higher doses and longer duration of use may increase the risk of blood pressure effects.
- Monitoring blood pressure regularly is advisable for those with hypertension or cardiovascular risk factors who are taking naproxen.
- Alternative pain relievers like acetaminophen (Tylenol) might be preferable for those at high risk, as it doesn't typically affect blood pressure.
- It's crucial to consult with a healthcare provider before starting or stopping any medication, especially if you have existing cardiovascular conditions. Other studies have also investigated the effects of NSAIDs, including naproxen, on blood pressure and cardiovascular risk 1. However, the study by 1 provides the most relevant and recent evidence regarding the specific question of naproxen's effect on blood pressure.
From the FDA Drug Label
NSAIDs, including naproxen, can lead to onset of new hypertension or worsening of pre-existing hypertension, either of which may contribute to the increased incidence of CV events. NSAIDs, including naproxen, should be used with caution in patients with hypertension Blood pressure (BP) should be monitored closely during the initiation of NSAID treatment and throughout the course of therapy.
Naproxen can increase blood pressure. It may lead to the onset of new hypertension or worsen pre-existing hypertension, which can contribute to the increased incidence of cardiovascular events. Patients taking naproxen should have their blood pressure monitored closely during treatment 2. Key considerations include:
- Using the lowest effective dose for the shortest possible duration
- Closely monitoring blood pressure during treatment
- Exercising caution when prescribing naproxen to patients with hypertension or other cardiovascular risk factors
From the Research
Naproxen and Blood Pressure
- Naproxen, a Nonsteroidal Anti-Inflammatory Drug (NSAID), may increase blood pressure in some individuals, particularly those with pre-existing hypertension 3, 4, 5, 6.
- Studies have shown that naproxen can raise blood pressure, although the extent of this effect may vary depending on the individual and the specific circumstances 7, 3, 6.
- A study published in 2011 found that naproxcinod, a derivative of naproxen, had a smaller effect on blood pressure compared to naproxen itself 7.
- Another study published in 1996 noted that the rise in mean arterial pressure associated with NSAID use, including naproxen, is relatively small, approximately 5 mm Hg 3.
- However, the same study also suggested that certain subgroups, such as the elderly and patients with pre-existing hypertension, may be at increased risk of developing hypertension during exposure to NSAIDs like naproxen 3.
- More recent guidelines recommend avoiding NSAIDs, including naproxen, in patients with treatment-resistant hypertension, high risk of cardiovascular disease, and severe chronic kidney disease (CKD) 4.
- For patients with high cardiovascular risk, naproxen or celecoxib are preferred if NSAID treatment cannot be avoided 4.
- Monitoring of blood pressure and renal function is recommended when using NSAIDs like naproxen, especially in patients with pre-existing hypertension or kidney disease 4, 5, 6.
Special Considerations
- Patients taking antihypertensive medications should be monitored for high blood pressure, and the doses of antihypertensive medications should be adjusted if needed when using naproxen 5, 6.
- The combination of NSAIDs, including naproxen, and angiotensin inhibitors should be avoided whenever possible 5.
- Preventative strategies, such as using the lowest effective dose of naproxen for the shortest possible time, monitoring renal function, and adjusting antihypertensive medications as needed, can help minimize the risks associated with naproxen use 4, 5.