Misuse of Non-SteroidalAntiInflammatory Drugs in Chronic hypertensive patients in samawah city

Author(s): Ruaa Jawad Jaber
Date: 08/10/2026
doi: https://doi.org/10.5281/zenodo.8425890

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Abstract

Nonsteroidal anti-inflammatory drugs (NSAIDs) are among the most commonly used and over-the
counter medications for pain relief and control of inflammation. Unsupervised NSAID ingestion may 
cause dangerous consequences by blocking blood pressure control in patients with chronic hypertension. 
These effects result from sodium and fluid retention, inhibition of vasodilatory prostaglandins, and 
increased vascular resistance. NSAIDs may also antagonize antihypertensive drugs, particularly the 
angiotensin-converting enzyme inhibitors and the angiotensin receptor blockers. This study was 
conducted to examine the effect of nonsteroidal agent abuse on the blood pressure of hypertensive 
patients in Samawah city, Iraq, and assess the level of abuse, pattern of intake, patient knowledge of 
risks, and compliance with prescribed antihypertensive medications . 
The sample consisted of 150 hypertensive patients, of whom most were in the 46 to 60-year age group; 
females made up 70.7% of the total. Forty-seven percent of the cohort used NSAIDs, with 56.7% of 
users doing so without medical guidance. A higher prevalence of change in blood pressure was also 
found in NSAID users (33.3%), among whom 22% experienced an elevation in blood pressure. 
Although statistical tests did not significant to show a significant difference in systolic or 
diastolicpressure between users and nonusers of these medications, the clinical implications are 
nonetheless interesting. Furthermore, the knowledge gap was high, with 62% of participants being 
unaware of the cardiovascular and renal risks of NSAID use. A weak, but statistically significant 
correlation was found between medication adherence and systolic pressure and the number of first-line 
antihypertensive drugs, and diastolic pressure . 
In conclusion, the misuse of NSAIDs is common and can be devastating for patients with high blood 
pressure, especially low health literacy patients. These data highlight the importance of patient 
education, improved physician-patient communication, and the adoption of safer, evidence-based 
alternatives for pain management to reduce blood-pressure instability and associated complications . 

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