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Attenuation of the effectiveness of antihypertensive therapy by non-steroidal anti-inflammatory (NSAI) drugs has been attributed to inhibition of systemic or renal vasodilator prostaglandin synthesis, or a combination of both. Indomethacin is a NSAI drug with both renal and extrarenal cyclo-oxygenase inhibition properties. Sulindac is a relatively selective cyclo-oxygenase inhibitor said not to affect urinary prostaglandin excretion. This study examines the relative effect on blood pressure of 4 weeks' treatment, with indomethacin 25 mg three times daily and sulindac 200 mg twice daily, in a randomized placebo controlled trial in 26 hypertensive subjects. In nine patients treated with indomethacin, supine blood pressure rose 11 mmHg systolic and 4 mmHg diastolic by the end of the first week, whereas nine subjects treated with sulindac showed a fall in blood pressure similar to the trend seen in placebo-treated subjects. Indomethacin treatment inhibited renal cyclo-oxygenase with a 78% reduction in urinary prostaglandin E2 excretion and 89% suppression of plasma renin activity. Neither measurement was affected by sulindac. Extrarenal cyclo-oxygenase activity was inhibited by both indomethacin and sulindac with serum thromboxane B2 decreasing by 96% and 69% respectively. The results suggest that the pressor effect of NSAI drugs is predominantly related to renal cyclo-oxygenase inhibition. the lack of effect of sulindac on blood pressure may make it a safer therapeutic option if NSAI drug therapy is necessary in the hypertensive patient.
I B Puddey, and
L J Beilin, and
R Vandongen, and
R Banks, and
I Rouse
April 1986,
British medical journal (Clinical research ed.),
I B Puddey, and
L J Beilin, and
R Vandongen, and
R Banks, and
I Rouse
May 1986,
British medical journal (Clinical research ed.),
I B Puddey, and
L J Beilin, and
R Vandongen, and
R Banks, and
I Rouse
January 1984,
Clinical and experimental hypertension. Part A, Theory and practice,
I B Puddey, and
L J Beilin, and
R Vandongen, and
R Banks, and
I Rouse
January 1982,
European journal of clinical pharmacology,
I B Puddey, and
L J Beilin, and
R Vandongen, and
R Banks, and
I Rouse
May 1987,
Japanese journal of medicine,
I B Puddey, and
L J Beilin, and
R Vandongen, and
R Banks, and
I Rouse
August 1991,
Sheng li xue bao : [Acta physiologica Sinica],
I B Puddey, and
L J Beilin, and
R Vandongen, and
R Banks, and
I Rouse
September 2011,
Zhonghua xin xue guan bing za zhi,
I B Puddey, and
L J Beilin, and
R Vandongen, and
R Banks, and
I Rouse
January 1988,
Postgraduate medical journal,
I B Puddey, and
L J Beilin, and
R Vandongen, and
R Banks, and
I Rouse
September 2005,
Journal of human hypertension,
I B Puddey, and
L J Beilin, and
R Vandongen, and
R Banks, and
I Rouse
November 1987,
International journal of clinical pharmacology, therapy, and toxicology,
