A new study recently published by Harvard Medical School connected popular painkillers such as Tylenol, Motrin and Advil to the increase in hypertension and stress in middle-aged women. The study showed that these drugs may double the risk of developing high blood pressure in women who are regular users and that a significant percent of high blood pressure cases may be related to painkiller usage.
Statistics have shown that over two billion dollars are spent yearly on the painkiller industry, an overwhelming amount of money that has raised concern over the long-term usage of over-the-counter (OTC) drugs. Tylenol is the brand name for acetaminophen and is generally used for the temporary relief of minor aches and pains as well as for fever reduction.
Acetaminophen is preferred over ibuprofen because it does not contain alcohol or aspirin. Functioning primarily in the bloodstream, acetaminophen is distributed throughout most bodily fluids and is metabolized in the liver. Through several chemical processes, the acetaminophen stops the synthesis of prostaglandins, second messengers within cells acted upon by other hormones in the central nervous system.
"It's the first time such a decisive result has been found," said Bernard Rosner, a professor of medicine at Harvard Medical School and one of the paper's authors, in a recent interview with the Washington Post.
Acetaminophen is known to relieve pain and fever, but not inflammation. Whereas aspirin and ibuprofen do tackle inflammation and are known as non-steroidal anti-inflammatory agents (NSAIDs). According to the FDA, these drugs are known to block two enzymes including cyclo-oxygenase COX-1 and cyclo-oxygenase COX-2.
It is COX-2, which generates pain signals, but COX-1 helps synthesize the protective mucus that lines the stomach. Inhibition of COX-1 leads to the sometimes grave side effects of NSAIDs like stomach irritation and bleeding.
When a person ingests acetaminophen, it is processed by a number of metabolic systems in the liver, including one called the P450 system. This results in an intermediate by-product, or metabolite, that is very reactive and can kill liver cells. This intermediate metabolite is normally converted to a benign final metabolite by an antioxidant in the liver called glutathione
Taken in overdose, however, the liver's normal processing of acetaminophen is overwhelmed, which causes the liver to get rid of a drug producing toxic substance. A dose of 10 to 15 grams or less, can produce liver injury. According to the Washington Post, an ingestion of 25 grams or more can lead to fatal liver disease. Liver injury becomes apparent two to three days after the overdose.
Women who took acetaminophen, the active ingredient in Tylenol, for 22 days a month or more had the highest anxiety risk, an estimate double that of regular users. Those who used the drug as little as one to four days a month had a greater risk than non-users. According to the Washington Post, people studied in this category were 22 percent more likely to report high blood pressure than those who took no painkillers.
The risk for those taking NSAIDs, including ibuprofen products such as Advil and Motrin and naproxen drugs such as Aleve, was similar. Heavy users, again, those who took the drugs at least 22 days a month had a risk of high blood pressure 86 percent higher than those who didn't use the drug. Light users again, those who took the drugs only one to four days a month carried a 17 percent higher risk.
The findings, according to the Washington Post, surprised the Food and Drug Administration officials, who this month began examining the magnitude of the painkiller's risk and whether Americans need more warnings to use it safely.
Although Rosner was confident in his results, he concluded that more studies need to be done in order to generalize his statements about all OTC drugs. The ostensible proof that Tylenol increases hypertension, however, shows that medication labels should be read carefully and proper dosage amounts should be administered.
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