Current Hypertension Reports

, Volume 12, Issue 4, pp 258–266

Do the Blood Pressure Effects of Nonsteroidal Antiinflammatory Drugs Influence Cardiovascular Morbidity and Mortality?


DOI: 10.1007/s11906-010-0120-8

Cite this article as:
Elliott, W.J. Curr Hypertens Rep (2010) 12: 258. doi:10.1007/s11906-010-0120-8


There are many theories about why selective inhibitors of the second isoform of cyclooxygenase (COX-2) increase cardiovascular risk. Although torcetrapib raises blood pressure and cardiovascular risk, it has been difficult to prove such a link for COX-2 inhibitors in randomized clinical trials. This review shows a significant correlation in placebo-controlled trials between the five agents’ elevations in blood pressures and their rate ratios for cardiovascular events. A larger body of evidence arises from randomized clinical trial comparisons of selective versus nonselective inhibitors of COX-2, but these results are heterogeneous for naproxen versus other traditional agents. The best current trial evidence comes from the centrally adjudicated placebo-controlled trials of celecoxib for colonic polyps: If the blood pressure did not rise at 1 or 3 years after randomization, cardiovascular risk did not significantly increase. Many more data will become available in 2013, after the only prospective clinical trial involving cardiovascular end points is completed.


Meta-analysisCelecoxibRofecoxibValdecoxibEtoricoxibParecoxibLumiracoxibCOX-2 inhibitorsIncident hypertensionComposite cardiovascular end point

Copyright information

© Springer Science+Business Media, LLC 2010

Authors and Affiliations

  1. 1.Division of PharmacologyPacific Northwest University of Health SciencesYakimaUSA