Can i take acetaminophen if i have high blood pressure

Q: Can you take acetaminophen with high blood pressure medication?

In general, people with high blood pressure should use acetaminophen or possibly aspirin for over-the-counter pain relief. Unless your health care provider has said its OK, you should not use ibuprofen, ketoprofen, or naproxen sodium.

Q: Does Tylenol make your blood pressure go up or down?

Only 21% of U.S. adults know that acetaminophen does not raise blood pressure, and those with high blood pressure are only slightly more aware of this fact (28%). 39% of U.S. adults with high blood pressure report acetaminophen is the over-the-counter medication they take most often for pain.

Regular Acetaminophen Use and Blood Pressure in People With Hypertension: The PATH-BP Trial

Iain M MacIntyre et al. Circulation. 2022.

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Regular Acetaminophen Use and Blood Pressure in People With Hypertension: The PATH-BP Trial
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Can you take acetaminophen with high blood pressure medication?
Does Tylenol make your blood pressure go up or down?

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Abstract

Background: Acetaminophen is widely used as first-line therapy for chronic pain because of its perceived safety and the assumption that, unlike nonsteroidal anti-inflammatory drugs, it has little or no effect on blood pressure (BP). Although observational studies suggest that acetaminophen may increase BP, clinical trials are lacking. We, therefore, studied the effects of regular acetaminophen dosing on BP in individuals with hypertension.

Methods: In this double-blind, placebo-controlled, crossover study, 110 individuals were randomized to receive 1 g acetaminophen 4× daily or matched placebo for 2 weeks followed by a 2-week washout period before crossing over to the alternate treatment. At the beginning and end of each treatment period, 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.

Results: One-hundred three patients completed both arms of the study. 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% 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.

Conclusions: Regular daily intake of 4 g acetaminophen increases systolic BP in individuals with hypertension by ≈5 mm Hg when compared with placebo; this increases cardiovascular risk and calls into question the safety of regular acetaminophen use in this situation. Registration: URL: https://www.clinicaltrials.gov; Unique identifier: NCT01997112. URL: https://www.clinicaltrialsregister.eu; Unique identifier: 2013-003204-40.

Keywords: acetaminophen; blood pressure; cardiovascular disease; chronic pain; hypertension.

Conflict of interest statement

Competing Interests

There are no competing interests to declare.

Figures

Figure 1. Flow diagram of study

Comment in

Acetaminophen-Induced Hypertension: Where Have All the "Safe" Analgesics Gone?
Smith SM, Cooper-DeHoff RM. Smith SM, et al. Circulation. 2022 Feb 8;145(6):424-426. doi: 10.1161/CIRCULATIONAHA.121.058068. Epub 2022 Feb 7. Circulation. 2022. PMID: 35130051 No abstract available.

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Can you take acetaminophen with high blood pressure medication?

In general, people with high blood pressure should use acetaminophen or possibly aspirin for over-the-counter pain relief. Unless your health care provider has said it's OK, you should not use ibuprofen, ketoprofen, or naproxen sodium.

Does Tylenol make your blood pressure go up or down?

Only 21% of U.S. adults know that acetaminophen does not raise blood pressure, and those with high blood pressure are only slightly more aware of this fact (28%). 39% of U.S. adults with high blood pressure report acetaminophen is the over-the-counter medication they take most often for pain.