Long-term paracetamol intake would cause an increase in blood pressure.

Accord­ing to a study, peo­ple with high blood pres­sure who take pre­scrip­tion parac­eta­mol may increase their risk of heart attack and stroke.

Doc­tors should con­sid­er the risks and ben­e­fits for patients tak­ing it for sev­er­al months, accord­ing to researchers from the Uni­ver­si­ty of Edinburgh.

Tak­ing the painkiller for headaches and fever is safe, they point out.

Oth­er experts say research in more peo­ple over a longer peri­od is need­ed to con­firm the findings.

Parac­eta­mol is wide­ly used around the world as a short-term rem­e­dy for aches and pains, but also pre­scribed to man­age chron­ic pain, despite lit­tle evi­dence of its ben­e­fits for long-term use.

Half a mil­lion peo­ple — one in 10 peo­ple — in Scot­land were pre­scribed the painkiller in 2018.

If they also have high blood pres­sure, a con­di­tion which affects one in three peo­ple in the UK, they may be at high­er risk, accord­ing to this trial.

He fol­lowed 110 vol­un­teers, two-thirds of whom were tak­ing med­ica­tion for high blood pres­sure or hypertension.

In a ran­dom­ized tri­al, they were asked to take 1g of parac­eta­mol four times a day for two weeks — a com­mon dose for patients with chron­ic pain — and then dum­my pills, or a place­bo, for anoth­er two weeks.

The tri­al showed parac­eta­mol raised blood pres­sure, ‘one of the strongest risk fac­tors for heart attacks and strokes’ — far more so than a place­bo, the Edin­burgh clin­i­cal phar­ma­col­o­gist said , Pro­fes­sor James Dear.

Researchers advise doc­tors to start patients with chron­ic pain on as low a dose of parac­eta­mol as pos­si­ble and to close­ly mon­i­tor those with high blood pres­sure and at risk for heart disease.

Arthri­tis is one of the lead­ing caus­es of chron­ic pain in the UK. A char­i­ty, Ver­sus Arthri­tis, said safer drugs to treat pain were need­ed along with oth­er aids, such as men­tal health sup­port and encour­age­ment to be phys­i­cal­ly active.

“If you are con­cerned about the risks of pain med­ica­tion, you should speak to a health­care pro­fes­sion­al to explore your options.” said Dr. Ben­jamin Ellis, con­sul­tant rheuma­tol­o­gist at Ver­sus Arthritis.

Prin­ci­pal inves­ti­ga­tor Dr Iain Mac­In­tyre, con­sul­tant in clin­i­cal phar­ma­col­o­gy, at NHS Loth­i­an, said: “This is not for short-term use of parac­eta­mol for headache or fever, which is , of course, good.”

Dr Dipen­der Gill, pro­fes­sor of clin­i­cal phar­ma­col­o­gy and ther­a­peu­tics at St George’s, Uni­ver­si­ty of Lon­don, said the study, pub­lished in the jour­nal Cir­cu­la­tion, found “a small but sig­nif­i­cant increase in blood pres­sure in a white Scot­tish pop­u­la­tion “but “many unknowns remain”.

“First, it is unclear whether the observed increase in blood pres­sure would be main­tained with longer-term use of parac­eta­mol,” he said.

“Sec­ond, it is unclear whether an increase in blood pres­sure attrib­ut­able to parac­eta­mol use would lead to an increased risk of car­dio­vas­cu­lar disease.”

A large US study pre­vi­ous­ly found a link between long-term parac­eta­mol use and an increased risk of heart attacks — but it could not prove one caused the other.

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