Skip to main content
British Medical Journal (Clinical Research Ed.) logoLink to British Medical Journal (Clinical Research Ed.)
. 1984 Dec 1;289(6457):1492–1494. doi: 10.1136/bmj.289.6457.1492

Influence of non-steroidal anti-inflammatory drugs on diuretic treatment of mild to moderate essential hypertension.

P P Koopmans, T Thien, F W Gribnau
PMCID: PMC1443776  PMID: 6439286

Abstract

In an open triple crossover study in 10 patients with mild to moderate essential hypertension the influence was investigated of adding indomethacin 50 mg, naproxen 250 mg, or sulindac 200 mg, each twice daily for four weeks, to diuretic treatment with hydrochlorothiazide 50 mg a day. After two weeks' treatment with indomethacin a slight increase in blood pressure was observed, whereas both sulindac and naproxen tended to enhance the antihypertensive effect of hydrochlorothiazide. After treatment for four weeks, however, the effects of all three drugs on blood pressure appeared to be blunted. Furthermore, body weight increased significantly during treatment with indomethacin but not during treatment with naproxen or sulindac. No significant changes were found for various biochemical variables, including concentrations of plasma electrolytes and serum creatinine and albumin, plasma renin activity, plasma aldosterone concentration, and 24 hour urinary excretion of sodium and potassium, with the exception, however, of an increase in plasma potassium concentration during treatment with indomethacin. These observations suggest that the interaction of indomethacin, naproxen, and sulindac with diuretic treatment in mild to moderate essential hypertension is transient and of minor clinical importance.

Full text

PDF
1492

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Ciabattoni G., Cinotti G. A., Pierucci A., Simonetti B. M., Manzi M., Pugliese F., Barsotti P., Pecci G., Taggi F., Patrono C. Effects of sulindac and ibuprofen in patients with chronic glomerular disease. Evidence for the dependence of renal function on prostacyclin. N Engl J Med. 1984 Feb 2;310(5):279–283. doi: 10.1056/NEJM198402023100502. [DOI] [PubMed] [Google Scholar]
  2. Drayer J. I., Benraad T. J. The reliability of the measurement of plasma renin activity by radioimmunoassay. Clin Chim Acta. 1975 Jun 20;61(3):309–324. doi: 10.1016/0009-8981(75)90421-0. [DOI] [PubMed] [Google Scholar]
  3. Epstein M., Lifschitz M. D. Volume status as a determinant of the influence of renal PGE on renal function. Nephron. 1980;25(4):157–159. doi: 10.1159/000181774. [DOI] [PubMed] [Google Scholar]
  4. Fujita T., Yamashita N., Yamashita K. Effect of indomethacin on antihypertensive action of captopril in hypertensive patients. Clin Exp Hypertens. 1981;3(5):939–952. doi: 10.3109/10641968109033714. [DOI] [PubMed] [Google Scholar]
  5. Kimberly R. P., Bowden R. E., Keiser H. R., Plotz P. H. Reduction of renal function by newer nonsteroidal anti-inflammatory drugs. Am J Med. 1978 May;64(5):804–807. doi: 10.1016/0002-9343(78)90520-x. [DOI] [PubMed] [Google Scholar]
  6. Kramer H. J., Düsing R., Stinnesbeck B., Prior W., Bäcker A., Eden J., Kipnowski J., Glänzer K., Krück F. Interaction of conventional and antikaliuretic diuretics with the renal prostaglandin system. Clin Sci (Lond) 1980 Jul;59(1):67–70. doi: 10.1042/cs0590067. [DOI] [PubMed] [Google Scholar]
  7. Levenson D. J., Simmons C. E., Jr, Brenner B. M. Arachidonic acid metabolism, prostaglandins and the kidney. Am J Med. 1982 Feb;72(2):354–374. doi: 10.1016/0002-9343(82)90826-9. [DOI] [PubMed] [Google Scholar]
  8. Lifschitz M. D. Renal effects of nonsteroidal anti-inflammatory agents. J Lab Clin Med. 1983 Sep;102(3):313–323. [PubMed] [Google Scholar]
  9. Pedrinelli R., Magagna A., Salvetti A. The effect of oxprenolol and indomethacin on renin and aldosterone of normal subjects during low sodium diet. Eur J Clin Invest. 1982 Apr;12(2):107–111. doi: 10.1111/j.1365-2362.1982.tb00946.x. [DOI] [PubMed] [Google Scholar]
  10. Salvetti A., Arzilli F., Pedrinelli R., Beggi P., Motolese M. Interaction between oxprenolol and indomethacin on blood pressure in essential hypertensive patients. Eur J Clin Pharmacol. 1982;22(3):197–201. doi: 10.1007/BF00545214. [DOI] [PubMed] [Google Scholar]
  11. Steiness E., Waldorff S. Different interactions of indomethacin and sulindac with thiazides in hypertension. Br Med J (Clin Res Ed) 1982 Dec 11;285(6356):1702–1703. doi: 10.1136/bmj.285.6356.1702-a. [DOI] [PMC free article] [PubMed] [Google Scholar]
  12. Tan S. Y., Mulrow P. J. Inhibition of the renin-aldosterone response to furosemide by indomethacin. J Clin Endocrinol Metab. 1977 Jul;45(1):174–176. doi: 10.1210/jcem-45-1-174. [DOI] [PubMed] [Google Scholar]
  13. Vallotton M. B., Favre L., Classon P. Agents anti-inflammatoires non-stéroïdiens, diurétiques et fonction rénale: une mise en garde. Schweiz Med Wochenschr. 1983 Aug 27;113(34):1198–1201. [PubMed] [Google Scholar]
  14. Watkins J., Abbott E. C., Hensby C. N., Webster J., Dollery C. T. Attenuation of hypotensive effect of propranolol and thiazide diuretics by indomethacin. Br Med J. 1980 Sep 13;281(6242):702–705. doi: 10.1136/bmj.281.6242.702. [DOI] [PMC free article] [PubMed] [Google Scholar]
  15. Wing L. M., Bune A. J., Chalmers J. P., Graham J. R., West M. J. The effects of indomethacin in treated hypertensive patients. Clin Exp Pharmacol Physiol. 1981 Sep-Oct;8(5):537–541. doi: 10.1111/j.1440-1681.1981.tb00763.x. [DOI] [PubMed] [Google Scholar]

Articles from British Medical Journal (Clinical research ed.) are provided here courtesy of BMJ Publishing Group

RESOURCES