Non-steroidal anti-inflammatory drugs (NSAIDs) are one of the most widely used classes of drugs but they are associated with adverse cardiovascular safety, including raised blood pressure.
Researchers randomly assigned 444 patients with osteoarthritis or rheumatoid arthritis who either had, or were at increased risk, of coronary artery disease to daily celecoxib, ibuprofen or naproxen.
After four months, they found that the mean change from baseline in 24-hour ambulatory systolic blood pressure was not significant for celecoxib (-0.3mmHg) or naproxen (+1.6mmHg), but increased significantly in the ibuprofen group (+3.7mmHg) compared with both baseline and celecoxib.
Significantly more ibuprofen- (23.2%) and naproxen-treated patients (19.0%) became hypertensive during treatment compared with the celecoxib group (10.3%).
Reporting in the European Heart Journal (online, 28 August 2017), the researchers said that prescribers should weigh up the benefits of NSAIDs against their risks, particularly in the case of ibuprofen
 Ruschitzka F, Borer J, Krum H et al. Differential blood pressure effects of ibuprofen, naproxen, and celecoxib in patients with arthritis: the PRECISION-ABPM (Prospective Randomized Evaluation of Celecoxib Integrated Safety Versus Ibuprofen or Naproxen Ambulatory Blood Pressure Measurement) Trial. Eur Heart J 2017;00,1–11. doi: 10.1093/eurheartj/ehx508