This Article Full Text Full Text (PDF) All Versions of this Article: 43/3/573    most recent 01.HYP.0000115921.55353.e0v1 Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Izhar, M. Articles by Bakris, G. L. Search for Related Content PubMed PubMed Citation Articles by Izhar, M. Articles by Bakris, G. L. Pubmed/NCBI databases Compound via MeSH Substance via MeSH Hazardous Substances DB CELECOXIB Medline Plus Health Information Hispanic-American Health Related Collections Other hypertension Clinical Studies Other Treatment

(Hypertension. 2004;43:573.)
© 2004 American Heart Association, Inc.

Scientific Contributions

Effects of COX Inhibition on Blood Pressure and Kidney Function in ACE Inhibitor-Treated Blacks and Hispanics

Munavvar Izhar; Tunji Alausa; Amy Folker; Elena Hung; George L. Bakris

From Department of Preventive Medicine, Section of Hypertension/Clinical Research Rush Presbyterian/St. Luke’s Medical Center, Chicago, Ill.

Correspondence to Dr George L. Bakris, Rush Medical Center, 1700 W. Van Buren St, Suite 470, Chicago, IL 60612. Email george_l_bakris{at}rush.edu

Cyclo-oxygenase (COX) inhibitors attenuate the antihypertensive effects of angiotensin-converting enzyme (ACE) inhibitors and reduce kidney function. The study tests the hypothesis that these two classes of drugs have similar effects on glomerular filtration rate (GFR) and 24-hour blood pressure. The primary endpoint was change in 24-hour systolic blood pressure. Using a randomized crossover design, 25 black and Hispanic hypertensive participants (mean age 58±3 years) with osteoarthritis were studied. All participants received an ACE inhibitor at baseline. Once systolic blood pressure was <140 mm Hg, either celecoxib 200 mg/d or diclofenac 75 mg twice daily for 4 weeks was started. After measurements were obtained, all participants underwent a 2-week washout period and crossed over to the other drug for 4 weeks. A significant difference in mean 24-hour systolic blood pressure was noted between groups at 4 weeks (+4.1±1.1 mm Hg diclofenac versus +0.6±0.6 mm Hg celecoxib; P=0.01). However, because celecoxib has duration of action shorter than 24 hours, we compared ambulatory values at celecoxib trough and peak activities. At peak, no difference in systolic blood pressure was noted between agents (+3.6±0.04 mm Hg diclofenac versus +4.2±1.9 mm Hg celecoxib; P=0.67). GFR was also differentially affected at 24 hours (-9.9±2.4 mL/min diclofenac versus -0.4±1.2 mL/min celecoxib; P=0.01). We conclude that diclofenac and celecoxib increase systolic blood pressure at peak levels; however, these agents differ in their 24-hour effects. Differences observed in blood pressure response between COX inhibitors may not be related in their sensitivity but rather their dosing frequency.

Key Words: kidney • hypertension • glomerular filtration rate

This article has been cited by other articles:

				S. D. Solomon, M. A. Pfeffer, J. J.V. McMurray, R. Fowler, P. Finn, B. Levin, C. Eagle, E. Hawk, M. Lechuga, A. G. Zauber, et al. Effect of Celecoxib on Cardiovascular Events and Blood Pressure in Two Trials for the Prevention of Colorectal Adenomas Circulation, September 5, 2006; 114(10): 1028 - 1035. [Abstract] [Full Text] [PDF]

				I. Fleming Signaling by the Angiotensin-Converting Enzyme Circ. Res., April 14, 2006; 98(7): 887 - 896. [Abstract] [Full Text] [PDF]

				I. Fleming, K. Kohlstedt, and R. Busse New fACEs to the Renin-Angiotensin System Physiology, April 1, 2005; 20(2): 91 - 95. [Abstract] [Full Text] [PDF]

				K. Kohlstedt, R. Busse, and I. Fleming Signaling via the Angiotensin-Converting Enzyme Enhances the Expression of Cyclooxygenase-2 in Endothelial Cells Hypertension, January 1, 2005; 45(1): 126 - 132. [Abstract] [Full Text] [PDF]