No Adverse Effect of Non-Steroidal Anti-Inflammatory Drugs, Sulindac and Diclofenac Sodium, on Blood Pressure Control with a Calcium Antagonist, Nifedipine, in Elderly Hypertensive Patients

Effect of non-steroidal anti-inflammatory drug (NSAID) on blood pressure (BP) control was evaluated in elderly hypertensive patients treated with calcium antagonist. The study was based on a randomized, crossover design to compare the effect of an NSAID., sulindac, with that of another NSAID., diclofenac sodium, in the hypertension treatment. The study was completed in six elderly female subjects (the average age: 66±3 year) whose systolic BP and diastolic BP were more than 160 mmHg and more than 95 mmHg, respectively. When BP was controlled by nifedipine (20 mg×2 per day in slow releasing form) within normal limits, sulindac (100 mg×3 per day) or diclofenac sodium (25 mg × 3 per day) was administered for a week. After one week-washout period, the other NSAID was substituted. Plasma and urinary variables were measured on the final day of each study period. The average systolic BP and diastolic BP and the entry of study were 167 ±5 mmHg and 93 ±5 mmHg, respectively. Nifedipine significantly decreased the systolic BP to 140±4 mmHg (P <0.02) and the diastolic BP to 84±4 mmHg (P < 0.05). Addition of either sulindac or diclofenac sodium did not affect BP., whereas urinary PGE₂ excretion and plasma renin activity were significantly inhibited. Plasma creatinine and electrolyte concentration were not changed by the NSAIDs. The results indicate that either sulindac or diclofenac sodium does not interfere with control of hypertension by a calcium antagonist, nifedipine in elderly hypertensive patients. And, it is suggested that renal PGEs does not play an evident role in BP control with nifedipine.