# Bloeddrukeffecten van ibuprofen, naproxen en celecoxib bij artritis: PRECISION-ABPM

*geplaatst 2017-11-21 · Hypertensie · European heart journal · doi 10.1093/eurheartj/ehx508 · https://hartvaat.nl/2017/11/21/bloeddrukeffecten-van-ibuprofen-naproxen-en-celecoxib-bij-artritis-precision-abp/*

PRECISION-ABPM substudie die de bloeddrukeffecten van drie NSAID's vergeleek bij artritispatiënten met 24-uurs ambulante meting. Celecoxib had het gunstigste profiel.

## English: 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.

The PRECISION-ABPM substudy showed differential blood pressure effects among NSAIDs, with celecoxib having the most favorable profile (minimal BP increase) compared with ibuprofen (significant increase) and naproxen. The 24-hour ambulatory data informed NSAID selection in hypertensive patients.

## Abstract (original, from the publication)

AIMS: Non-steroidal anti-inflammatory drugs (NSAIDs), both non-selective and selective cyclooxygenase-2 (COX-2) inhibitors, are among the most widely prescribed drugs worldwide, but associate with increased blood pressure (BP) and adverse cardiovascular (CV) events. PRECISION-ABPM, a substudy of PRECISION was conducted at 60 sites, to determine BP effects of the selective COX-2 inhibitor celecoxib vs. the non-selective NSAIDs naproxen and ibuprofen. METHODS AND RESULTS: In this double-blind, randomized, multicentre non-inferiority CV-safety trial, 444 patients (mean age 62 ± 10 years, 54% female) with osteoarthritis (92%) or rheumatoid arthritis (8%) and evidence of or at increased risk for coronary artery disease received celecoxib (100-200 mg bid), ibuprofen (600-800 mg tid), or naproxen (375-500 mg bid) with matching placebos in a 1: 1: 1 allocation, to assess the effect on 24-h ambulatory BP after 4 months. The change in mean 24-h systolic BP (SBP) in celecoxib, ibuprofen and naproxen-treated patients was -0.3 mmHg [95% confidence interval (CI), -2.25, 1.74], 3.7 (95% CI, 1.72, 5.58) and 1.6 mmHg (95% CI, -0.40, 3.57), respectively. These changes resulted in a difference of - 3.9 mmHg (P = 0.0009) between celecoxib and ibuprofen, of - 1.8 mmHg (P = 0.12) between celecoxib and naproxen, and of - 2.1 mmHg (P = 0.08) between naproxen and ibuprofen. The percentage of patients with normal baseline BP who developed hypertension (mean 24-h SBP ≥ 130 and/or diastolic BP ≥ 80 mmHg) was 23.2% for ibuprofen, 19.0% for naproxen, and 10.3% for celecoxib (odds ratio 0.39, P = 0.004 and odds ratio 0.49, P = 0.03 vs. ibuprofen and naproxen, respectively). CONCLUSIONS: In PRECISION-ABPM, allocation to the non-selective NSAID ibuprofen, compared with the COX-2 selective inhibitor celecoxib was associated with a significant increase of SBP, and a higher incidence of new-onset hypertension. CLINICALTRIALS: gov number NCT00346216.

Auteurs: Frank Ruschitzka, Jeffrey S Borer, Henry Krum, Andreas J Flammer, Neville D Yeomans, Peter Libby, Thomas F Lüscher, Daniel H Solomon, M Elaine Husni, David Y Graham, Deborah A Davey, Lisa M Wisniewski, Venu Menon, Rana Fayyad, Bruce Beckerman, Dinu Iorga, A Michael Lincoff, Steven E Nissen

---
Bron: European heart journal, https://doi.org/10.1093/eurheartj/ehx508. Bijgewerkt 2026-07-03T13:26:17Z. Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.