Paracetamol is a mediation officially approved by the Spanish Agency of Medicinesand Health Products (AEMPS). That is to say, it has all the quality certificates from the health authorities to treat different health aspects,
In this sense, it is a medicine that belongs to the group of medicines known as analgesics or antipyretics. Thus, it is indicated as a treatment for mild to moderate pain symptoms and for fever.
Like any medicine, the consumption of paracetamol can also entail a series of side effects, which are listed in the package leaflet of the medication itself.
The AEMPS informs that the consumption of paracetamol can have side effects considered rare (affecting 1 in 1,000 patients), such as discomfort, low blood pressure (hypotension) and increased levels of transaminases in the blood.
Transaminases are a set of enzymes distributed throughout the body that are involved in the function of metabolism and the production of different amino acids.
Transaminases are a set of enzymes distributed throughout the body that are involved in the function of metabolism and the production of different amino acids. They are generally located in the liver and heart, and elevated levels can cause inflammation.
In very rare cases (up to 1 in 10,000 patients), paracetamol can also cause kidney disease, cloudy urine, allergic dermatitis (skin rash), jaundice (yellowing of the skin), blood disorders (agranulocytosis, leukopenia, neutropenia, hemolytic anemia) and hypoglycemia (low blood sugar).
How paracetamol consumption affects heart health
It is not yet known exactly how the use of acetaminophen can affect heart health. However, it is well established that chronic prescription non-steroidal anti-inflammatory drugs (NSAIDs) and cyclooxygenase-2 (COX-2) inhibitors are associated with increased cardiovascular (CV) risk.
For this reason, paracetamol has traditionally been indicated as the analgesic drug of choice in patients with advanced age or vascular pathology. However, there are few prospective studies on the safety of paracetamol in patients at high cardiovascular risk.
A study published in the ‘Revista de Nefrología’ indicates possible links between prolonged consumption of paracetamol and its influence on cardiovascular risk.
The study involved 33 patients with coronary artery disease and conventional treatment (statins, acetylsalicylic acid, angiotensin II receptor antagonists or angiotensin-converting enzyme inhibitors) in a randomized, double-blind, crossover study comparing the effects of 1 g x 8 hours of paracetamol versus placebo.
Specifically, treatment periods lasted 2 weeks. Blood pressure was monitored on an ambulatory basis for 24 hours. Other biological and hemodynamic parameters were also investigated simultaneously.
Medication and study outcome
The study concludes that «relative to placebo, paracetamol treatment induced an increase of approximately 3/2 mmHg in mean 24-hour BP: systolic BP: 122.4 ± 11.9 mmHg vs. 125.3 ± 12.0 mmHg; p = 0.02. Diastolic BP: 73.2 ± 6.9 mmHg vs. 75.4 ± 7.9 mmHg; p = 0.02».
Specifically, no significant differences were found in heart rate, components of the renin-angiotensin system, prostaglandin metabolism, renal biochemical parameters, endothelial function or platelet function.
Finally, this research work concludes that Paracetamol as a drug increases blood pressure in patients with coronary artery disease.
Thus, based on this study, it is estimated that the prescription of paracetamol in this type of situation should be carried out with the same precautions established for NSAIDs and COX-2 inhibitors.
In any case, there is no clear evidence on the effects that paracetamol consumption may have on heart health. What seems clear is that it is safer than NSAIDs or COX-2 inhibitors.