When thinking about how painkillers work, it helps to understand what is happening on the inside. You may see advertisements on television which refer to “targeted pain relief” that is fast-acting and will stop the pain in a specific area.

While taking something like paracetamol or ibuprofen, for example, helps with pain relief, the medicine hasn’t actually pinpointed where your pain is and gone directly to the source.

Medicine has to make its way around the body to find the source of inflammation and calm the effects of pain. For most people, it’s absolutely fine to let painkillers do what they have to, but for those with high blood pressure it is important to know what else the medicine may be doing in your body and why there could be risks.

It is important to remember that pain itself can raise blood pressure through a stress response and changes in the nervous system. Measuring blood pressure while in pain may give higher than usual readings, so this should be borne in mind.

However, concerns have also been raised about whether painkillers themselves can paradoxically increase blood pressure. Studies have shown that some of these medicines raise blood pressure by a fraction, due to a small level of water retention.

This isn’t a problem for most people who take these medicines occasionally, or over a short-term period (a few days).  However, someone with high blood pressure may want to avoid the risk associated with their blood pressure being higher for a sustained period if it can be avoided. A key point is that short term or occasional use of painkillers is usually not a concern and there is no evidence to suggest there is harm in this context.

Problems may primarily occur if individuals with high blood pressure find themselves using painkillers for more than a few days in a row to combat chronic pain problems. It can also cause problems in cases where certain medicines may interact to create a dramatic increase without the individual realising it.

There are some over the counter medicines you should know that could raise blood pressure if used persistently. The most common are preparations that include:

•    Paracetamol (also known as acetaminophen or Tylenol in the USA)
•    Ibuprofen 
•    Naproxen

Any medicine known to be a non-steroidal anti-inflammatory drug (NSAIDs, such as ibuprofen and naproxen) can increase blood pressure. Some other medicines, like treatments for cold & flu, as well as some natural supplements, may also raise blood pressure because they may contain small amounts of other ingredients that may be stimulants or constrict blood vessels.

As mentioned, short term use of common painkillers like paracetamol, every now and then, is usually of no concern even for those with high blood pressure.

Only with longer term use may problems begin to emerge, and a clinician should be consulted in this context for best treatment options.

Some studies show that aspirin, while not commonly used in the UK, may be used for pain relief in those with high blood pressure. However, chronic use of aspirin can also cause other issues such as gastric irritation.

High blood pressure is often a silent condition and only detected with a blood pressure measurement. Sometimes if blood pressure is very high, symptoms that may appear include:

•    Frequent headaches
•    Chest pain
•    Trouble breathing
•    Long periods of fatigue
•    Dizziness
•    Changes in vision
•    Nosebleeds

Yes, if they are used occasionally or for a short-term period. 

If you have chronic pain and are using painkillers for more than a few days, it is advisable to check with a GP or a pharmacist about what prescription or over the counter medicine should be used for pain relief.

We have information on high blood pressure which you can view here.

If you have any questions about these procedures, our cardiology team at OneWelbeck will be happy to discuss options with you.

You can also get in touch with us here.