(Hypertension. 2000;36:461.)
© 2000 American Heart Association, Inc.
Scientific Contributions |
Effect of Indomethacin on Blood Pressure Lowering by Captopril and Losartan in Hypertensive Patients
From the Endocrinology-Hypertension Division, Brigham and Women’s Hospital, Medical Service, Brockton/West Roxbury VA Medical Center, and Harvard Medical School, Boston, Mass (P.R.C., T.J.M., S.L.S.), and the Clinical Development Department, US Human Health, Merck and Co, Inc, West Point, Pa (T.J.M., E.B., L.G., C.F., P.D., L.D.).
Correspondence to Paul R. Conlin, MD, Endocrinology-Hypertension Division, Brigham and Women’s Hospital, 221 Longwood Ave, Boston, MA 02115. E-mail pconlin{at}rics.bwh.harvard.edu
Abstract—NSAIDs are known to attenuate the effects of some antihypertensive medications. It is not known whether the new class of angiotensin II receptor antagonists is similarly affected. We conducted a multicenter study assessing the effect of indomethacin on the antihypertensive effects of losartan and captopril. After 4 weeks of placebo washout, hypertensive patients received 6 weeks of active antihypertensive therapy with either 50 mg losartan once daily (n=111) or 25 mg captopril twice daily for 1 week, which was increased to 50 mg twice daily for 5 weeks (n=105). This was followed by 1 week of concomitant therapy with indomethacin (75 mg daily). The primary outcome measure was the change in mean 24-hour ambulatory diastolic blood pressure after the addition of indomethacin. Both captopril and losartan significantly lowered ambulatory diastolic blood pressure (losartan -5.3 mm Hg, P<0.001; captopril -5.6 mm Hg, P<0.001) after 6 weeks of therapy. Indomethacin significantly attenuated the 24-hour ambulatory diastolic blood pressure for both losartan (2.2 mm Hg, P<0.05) and captopril (2.7 mm Hg, P<0.001) and also attenuated the effect of captopril on trough sitting diastolic blood pressure. Changes in daytime diastolic blood pressure (7:00 AM to 11:00 PM) were similar to the 24-hour response in both groups. Nighttime diastolic blood pressure (11:01 PM to 6:59 AM) was significantly attenuated in captopril-treated patients (2.0 mm Hg, P<0.05), but losartan was unaffected (0.4 mm Hg). Thus, concurrent treatment with indomethacin similarly attenuates the 24-hour antihypertensive response to losartan and captopril.
Key Words: hypertension, essential • indomethacin • losartan • captopril • blood pressure
This article has been cited by other articles:
 |
|
 |
|
  P. A. Sarafidis and G. L. Bakris Resistant Hypertension An Overview of Evaluation and Treatment. J. Am. Coll. Cardiol., November 25, 2008; 52(22): 1749 - 1757. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 D. A. Calhoun, D. Jones, S. Textor, D. C. Goff, T. P. Murphy, R. D. Toto, A. White, W. C. Cushman, W. White, D. Sica, et al. Resistant Hypertension: Diagnosis, Evaluation, and Treatment: A Scientific Statement From the American Heart Association Professional Education Committee of the Council for High Blood Pressure Research Circulation, June 24, 2008; 117(25): e510 - e526. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 D. A. Calhoun, D. Jones, S. Textor, D. C. Goff, T. P. Murphy, R. D. Toto, A. White, W. C. Cushman, W. White, D. Sica, et al. Resistant Hypertension: Diagnosis, Evaluation, and Treatment: A Scientific Statement From the American Heart Association Professional Education Committee of the Council for High Blood Pressure Research Hypertension, June 1, 2008; 51(6): 1403 - 1419. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
W. B. White, J. Kent, A. Taylor, K. M. Verburg, J. B. Lefkowith, and A. Whelton Effects of Celecoxib on Ambulatory Blood Pressure in Hypertensive Patients on ACE Inhibitors Hypertension, April 1, 2002; 39(4): 929 - 934. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 NSAIDs Attenuate the Effects of Newer Antihypertensives Journal Watch Cardiology, December 1, 2000; 2000(1201): 2 - 2. [Full Text]
|
|