Effects of celecoxib and rofecoxib on blood pressure and edema in patients > or =65 years of age with systemic hypertension and osteoarthritis.

Abstract

Concomitant use of nonsteroidal anti-inflammatory drugs (NSAIDs), including the cyclooxygenase-2 (COX-2) specific inhibitors, with antihypertensive medication is common practice for many patients with arthritis. This study evaluated the effects of celecoxib 200 mg/day and rofecoxib 25 mg/day on blood pressure (BP) and edema in a 6-week, randomized, parallel-group, double-blind study in patients > or =65 years of age with osteoarthritis who were treated with fixed antihypertensive regimens. One thousand ninety-two patients received study medication (celecoxib, n = 549; rofecoxib, n = 543). Significantly more patients in the rofecoxib group compared with the celecoxib group developed increased systolic BP (change >20 mm Hg plus absolute value > or =140 mm Hg) at any time point (14.9% vs 6.9%, p <0.01). Rofecoxib caused the greatest increase in systolic BP in patients receiving angiotensin-converting enzyme inhibitors or beta blockers, whereas those on calcium channel antagonists or diuretic monotherapy receiving either celecoxib or rofecoxib showed no significant increases in BP. Clinically significant new-onset or worsening edema associated with weight gain developed in a greater percentage of patients in the rofecoxib group (7.7%) compared with the celecoxib group (4.7%) (p <0.05). Thus, in patients with controlled hypertension on a fixed antihypertensive regimen, careful monitoring of BP is warranted after the initiation of celecoxib or rofecoxib therapy.

• Authors: Andrew Whelton, William B White, Alfonso E Bello, Joseph A Puma, John G Fort, SUCCESS-VII Investigators
• Journal: The American journal of cardiology (Am J Cardiol) Vol. 90 Issue 9 Pg. 959-63 (Nov 01 2002) ISSN: 0002-9149 [Print] United States
• PMID: 12398962 (Publication Type: Clinical Trial, Comparative Study, Journal Article, Multicenter Study, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)

Chemical References

• Anti-Inflammatory Agents, Non-Steroidal
• Antihypertensive Agents
• Cyclooxygenase Inhibitors
• Lactones
• Pyrazoles
• Sulfonamides
• Sulfones
• rofecoxib
• Celecoxib

Topics

• Age Factors
• Aged
• Anti-Inflammatory Agents, Non-Steroidal (therapeutic use)
• Antihypertensive Agents (therapeutic use)
• Blood Pressure (drug effects)
• Celecoxib
• Cyclooxygenase Inhibitors (therapeutic use)
• Double-Blind Method
• Drug Evaluation
• Edema (complications, drug therapy)
• Female
• Heart Failure (complications, drug therapy)
• Humans
• Hypertension (complications, drug therapy)
• Lactones (therapeutic use)
• Male
• North America
• Osteoarthritis (complications, drug therapy)
• Pyrazoles
• Sulfonamides (therapeutic use)
• Sulfones
• Systole (drug effects)
• Treatment Outcome
• Weight Gain (drug effects)