- With Mayo Clinic rheumatologist
April Chang-Miller, M.D.
read biographyclose windowBiography of
April Chang-Miller, M.D.
April Chang-Miller, M.D.
Dr. April Chang-Miller is board certified in internal medicine and rheumatology and is a consultant in the Division of Rheumatology and Internal Medicine at Mayo Clinic in Arizona.
Dr. Chang-Miller's primary field is rheumatology with special interests in inflammatory joint diseases called seronegative spondyloarthropathies such as ankylosing spondylitis and psoriatic arthritis. She also cares for patients with rheumatoid arthritis and polymyalgia rheumatica.
The New York City native is a graduate of the Yale University School of Medicine and had been with Mayo Clinic in Rochester, Minn., between 1991 and 2002 when she relocated to Mayo Clinic, Arizona. She is a fellow in the American College of Rheumatology and has been on the board of directors of the Arthritis Foundation North Central Chapter.
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Question
Arthritis pain medications: Do they raise blood pressure?
I take acetaminophen (Tylenol, others) every day to control joint pain from osteoarthritis. Recently, I heard that acetaminophen may increase my risk of high blood pressure. Is this true? If so, which arthritis pain medications are safe for my heart?
Answer
from April Chang-Miller, M.D.
It is true, but there's some debate about how much additional risk you take on when you use acetaminophen regularly. Unless you already have high blood pressure or other risk factors for heart disease, acetaminophen is relatively safe for your heart.
Other over-the-counter arthritis medications — specifically, the nonsteroidal anti-inflammatory drugs (NSAIDs) ibuprofen (Advil, Motrin, others) and naproxen (Aleve, others) — seem to be a little riskier than is acetaminophen, as far as cardiovascular disease is concerned. Even so, many people with arthritis value the benefits of NSAIDs enough to accept their risks.
Keep in mind that medication isn't the only treatment for arthritis pain. Mild to moderate arthritis pain may be relieved with a combination of self-care measures and lifestyle changes, such as weight loss, exercise, heat or cold therapy, and physical therapy. Many doctors now recommend trying this combined approach before starting medication.
If you need medication to help manage your arthritis pain, use the lowest dose necessary for the shortest time possible. Also, discuss with your doctor which pain medication is most appropriate for your specific situation. All medications — prescription and nonprescription — have risks and potential side effects.
When taking over-the-counter pain relievers for arthritis, keep these tips in mind:
- Get your blood pressure checked regularly.
- Avoid alcohol.
- Tell your doctor about any herbal supplements, nutritional supplements or other medications you are taking.
Yucca: Can it relieve arthritis pain?
- Forman JP, et al. Frequency of analgesic use and risk of hypertension among men. Archives of Internal Medicine. 2007;167:394. Accessed April 7, 2009.
- Montgomery B. Does paracetamol cause hypertension? BMJ. 2008;336:1190. Accessed April 7, 2009.
- Solomon DH, et al. Subgroup analysis of cardiovascular risks associated with nonsteroidal antiinflammatory drugs and coxibs in specific patient groups. Arthritis & Rheumatism. 2008;59:1097. Accessed April 7, 2009.
- Patrigani P, et al. NSAIDs and cardiovascular disease. Heart. 2008;94:395. Accessed April 7, 2009.
- Antman E, et al. Use of nonsteroidal antiinflammatory drugs: An update for clinicians: A scientific statement from the American Heart Association. Circulation. 2007;115:1634. Accessed April 7, 2009.
