OTC painkillers may up women's blood pressure

MEDICAL MATTERS

March 03, 2006|By JUDY FOREMAN

Do over-the-counter painkillers raise blood pressure?

Some do, at least in women.

In a study published last year in Hypertension, a journal of the American Heart Association, researchers from the Nurses' Health Study looked at the records of more than 5,000 female nurses ages 34 to 77.

They found that those who took 500 milligrams or more a day of acetaminophen - such as Tylenol - were twice as likely to develop high blood pressure as those who didn't. Women who took 400 milligrams a day or more of ibuprofen - often marketed as Motrin or Advil - were 60 percent to 80 percent more likely to develop high blood pressure than those who didn't.

Aspirin, on the other hand, was not linked with increased risk.

For men, the link between over-the-counter painkillers and hypertension is less clear. A report from the Physicians' Health Study involving more than 8,200 male physicians was also published last year, in the Archives of Internal Medicine. It found no link between the onset of hypertension and the painkillers.

Overall, the heart association says one in three adult Americans has high blood pressure. Many don't know it, according to said Dr. Gary C. Curhan, an associate professor at Harvard Medical School and a coauthor of the nurses' study.

It's not clear why the painkillers would be linked with higher blood pressure, Curhan said, but one theory is that the drugs may interfere with the kidney's excretion of sodium, elevating blood pressure.

The drugs may also hamper the ability of blood vessel walls to relax, raising resistance to blood flow and increasing blood pressure.

So, if you take over-the-counter painkillers, said Dr. Richard Lange, chief of clinical cardiology at Johns Hopkins Hospital, take the minimum needed to control pain - and get your blood pressure checked regularly.

What happens, mentally and physically, after a miscarriage, and how long do these effects last?

The effects of a miscarriage, defined as the loss of a pregnancy before 20 weeks, depend on how long a woman was pregnant, and, to some extent, how much she wanted a baby.

If a woman misses a period, she may not even know she is pregnant, and miscarriage may be nothing more than an extra-heavy flow, said Dr. Isaac Schiff, chief of obstetrics and gynecology at Massachusetts General Hospital.

"As you go further along, say a miscarriage at 11 or 12 weeks, the bleeding can be quite heavy and the cramps, very severe. It's almost like labor," he said.

It can take a few weeks for hormone levels to return to a nonpregnant state, Schiff said. It can also take a week or so for bleeding to stop and several weeks for enlarged breasts to return to normal size.

Psychologically, the loss of a wanted pregnancy can take even longer to heal. Women should "treat it like a death. Don't trivialize it," Schiff said.

"In addition to feelings of loss, many women feel angry that their bodies aren't `working' correctly and guilt that they may somehow have caused the miscarriage, so support from family and friends can be especially helpful in letting go of self-blame," said Judy Norsigian, executive director of Our Bodies Ourselves, a Boston-based women's health advocacy group.

In years past, many women who miscarried had minor surgery, a D&C, or dilation and curettage, to remove any fetal tissue left in the uterus. A study in the New England Journal of Medicine last summer showed that a drug called misoprostol is nearly as effective as a D&C. The drug expels 84 percent of fetal tissue; a D&C expels 97 percent.

According to womens health.gov, the Web site of the National Women's Health Information Center, the first signs of miscarriage are vaginal bleeding and cramping. If a woman is pregnant and has either of these symptoms, she should call her doctor immediately.

Send your questions to foreman@baltsun.com.

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