The PATH-BP Trial Clinical Summary

PATH-BP clinical summary


Acetaminophen is widely used as first-line therapy for chronic pain because of its perceived safety and the assumption that, unlike nonsteroidal anti-inflammatory drugs, it has little or no effect on blood pressure (BP). Although observational studies suggest that acetaminophen may increase BP, clinical trials are lacking. We, therefore, studied the effects of regular acetaminophen dosing on BP in individuals with hypertension.


Regular daily intake of 4 g acetaminophen increases systolic BP in individuals with hypertension by ≈5 mmHg when compared with placebo; this increases cardiovascular risk and calls into question the safety of regular acetaminophen use in this situation.

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  • Clinical implications

    • To quote the PATH-BP study authors, “Acetaminophen should no longer be thought of as a ‘safe’ alternative analgesic to NSAIDs, at least with respect to hypertension”
    • Healthcare providers should be aware of these findings when considering acetaminophen (Tylenol and similar generics) for patients with hypertension, controlled or not. Caution should be taken when prescribing acetaminophen, particularly in those with increased cardiovascular risk, and opportunities to stop acetaminophen or reduce the dose should be considered
    • We encourage physicians, pharmacists, dentists, nurse practitioners and physician assistants to discuss their patients’ medical history with them, particularly if they have hypertension, before making a recommendation for the use of an OTC pain reliever

    Advil (ibuprofen) is part of a class of drugs called non-steroidal anti-inflammatory drugs (NSAIDs) that may raise blood pressure. Advil safely and effectively provides pain relief when used as directed. It has a proven safety profile over a 35-year brand history.

    Learn more about the clinically proven safety and efficacy of Advil.

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