A recent study has demonstrated that acetaminophen might bring some cardiovascular risk: Regular acetaminophen, compared with placebo, resulted in a significant increase in mean daytime systolic blood pressure, in a clinical trial reported in the journal Circulation.1

Acetaminophen, widely used for chronic pain because of its perceived safety and the assumption that it has little or no effect on blood pressure (BP), was studied in 103 patients with hypertension in a double-blind, placebo-controlled, crossover study.

Patients were randomized to receive either 1 g acetaminophen 4 times daily or matched placebo for 2 weeks, followed by a 2-week washout period before each participant crossed over to the alternate treatment. The participants' 24-hour ambulatory BPs were measured.

The primary outcome was a comparison of the change in mean daytime systolic BP from baseline to end of treatment between the placebo and acetaminophen arms.

Regular acetaminophen, compared with placebo, resulted in a significant increase in mean daytime systolic BP [132.8 +/- 10.5 to 136.5 +/- 10.1 mm Hg (acetaminophen) vs 133.9 +/- 10.3 to 132.5 +/- 9.9 mm Hg (placebo); P < 0.0001] with a placebo-corrected increase of 4.7 mm Hg [95% confidence interval (CI), 2.9-6.6] and mean daytime diastolic BP [81.2 +/- 8.0 to 82.1 +/- 7.8 mm Hg (acetaminophen) vs 81.7 +/- 7.9 to 80.9 +/- 7.8 mm Hg (placebo); P = 0.005] with a placebo-corrected increase of 1.6 mm Hg (95% CI, 0.5-2.7). Similar findings were seen for 24-hour ambulatory and clinic BPs.

The researchers concluded that regular daily intake of 4-g acetaminophen increases systolic BP in individuals with hypertension by approximately 5 mm Hg, when compared with placebo-increasing cardiovascular risk and questions the safety of regular acetaminophen use.

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