Is it okay for patients with uncomplicated hypertension to take NSAIDs such as ibuprofen, naproxyn, celecoxib, etc? Many can … but you need to be careful.
According to the experts at the Natural Medicines Comprehensive Database (NMCD), on average, NSAIDs increase BP by around 5 mmHg in patients with hypertension … but some patients are more susceptible than others.
Elevations are more likely in the elderly … obese men … and patients with diabetes, heart failure, or kidney or liver disease.
The NMCD tells us prescribers, “Tell patients with uncomplicated hypertension that occasional use of NSAIDs is usually okay … but daily use for just one week can reduce BP control.”
They also tell us prescribers:

• Monitor BP if a hypertensive patient starts a chronic NSAID. Explain that NSAIDs can also make BP meds less effective.
• Be careful about combining an NSAID with an ACE inhibitor or ARB … the combo can worsen BP and renal function.
• And watch for the “triple whammy”… an NSAID plus an ACEI or ARB plus a diuretic. This combo can push a patient into acute renal failure.
• Consider using a calcium channel blocker if a patient needs an antihypertensive that is less affected by NSAIDs.
• Don’t expect one NSAID to increase BP more or less than the others.
• Suggest naproxen if a chronic NSAID is needed for a patient with cardiovascular disease … not just hypertension.
• Naproxen seems to be the least likely to increase cardiovascular risk.

Here are some of my other blogs on NSAIDs:

• Study suggests NSAIDs raise risk of miscarriage
• Two OTC drugs give better pain relief than one for osteoarthritis
• Some NSAIDs potentially dangerous for heart attack survivors
• Cardiovascular safety of non-steroidal anti-inflammatory drugs (NSAIDs)
• Taking low-dose aspirin and NSAIDs can be a challenge
• Taking low-dose aspirin and NSAIDs can be a challenge (Part 2)
• New Warning Against Long-Term Use of Aspirin and Ibuprofen in Elderly