Nonsteroidal anti-inflammatory drugs hypertension with

Radack K, Deck C. Do nonsteroidal anti-inflammatory drugs interfere with blood pressure control in hypertensive patients J Gen Intern Med 1987 2(2) 108-12. 

Diabetes is a major risk factor for deterioration in renal function after angiography (2,7,13). Other factors variably associated with increased rates of CIN include age over 75 years, anemia, female gender, periprocedural volume depletion, heart failure, cirrhosis, hypertension, proteinuria, concomitant use of nonsteroidal anti-inflammatory drugs, and intra-arteriai injection (2,4,5,7,10,13,14,19,43,44). In the setting of acute myocardial infarction or PCI, hypotension or use of an intra-aortic balloon pump has been associated with a higher rate of acute renal failure after exposure to a contrast medium (13,50). Finally, high doses of CM also increase the likelihood of renal dysfunction (51). 

Houston MC, Weir M, Gray J, Ginsberg D, Szeto C, Kaihlenen PM, Sugimoto D, Runde M, Lefkowitz M. The effects of nonsteroidal anti-inflammatory drugs on blood pressures of patients with hypertension controlled by verapamil. Arch Intern Med 1995 155(10) 1049-54. 

The new nonsteroidal anti-inflammatory drugs, including the Cox II inhibitors, because of the vast range of arthritic diseases, require that careful selection of indications for initial product approval must be undertaken. Rarely do companies have the time or money to develop all the pain indications (acute, chronic use) or to study arthritic diseases prior to product launch. As with hypertension, the numbers of patients required in the database will be large for product approval, especially for safety. 

Lefkowitz M The effects of nonsteroidal anti-inflammatory drugs blood pressures of patients with hypertensic i controlled by verapamil. (1995) 155,1049-54. 

The role of concomitant medication is not clear due to the lack of good clinical studies [9]. It is recommended to stop nonsteroidal anti-inflammatory drugs, metformin for the risk of lactic acidosis with decreasing renal function, and diuretics. Usually, diuretics used for long-term treatment of hypertension and inhibitors of the renin-angiotensin system should not be discontinued. 

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