The effect of etoricoxib versus diclofenac on blood pressure in hypertensive patients.

Objective: To compare the effect of etoricoxib, a selective cyclooxygenase-2 inhibitor, with diclofenac, a non-selective nonsteroidal anti-inflammatory drug, on blood pressure in hypertensive patients.

Methods: The prospective observational study was conducted at Al-Hussein Medical City, Karbala, Iraq, from July 2018 to March 2019, and comprised patients with hypertension already on antihypertensive treatment. The subjects were divided into 2 equal groups. Those in group 1 received etoricoxib, while patients in group 2 received diclofenac sodium. They were followed up for 2 weeks. Pulse rate, blood pressure and renal indices were noted and compared between the groups. Data was analysed using 2-tailed t-test for continuous variables, and chi-square test for categorial ones.

Results: Of the 100 subjects, there were 50(50%) in group 1 with a mean age of 48.7±14.9 years including 15(30%) males, and the remaining 50(50%) were in group 2 with a mean age of 51.9 ± 13.4 years including 14(28%) males (p>0.05). The blood pressure was elevated above the normal upper limit in 16(32%) in group 1 patients compared to 6(12%) in group 2 (p=0.015). The mean rise in systolic blood pressure in group 1 was 16.2±15mmHg compared to 8.5±11 in group 2 (p=0.004), and the mean rise in diastolic blood pressure was 7.1±9 compared to 2.4±7 in the two groups, respectively (p=0.004). The mean increase in pulse rate was 8.1±16 in group 1 compared to 6.2±14 in group 2 (p=0.529). There was no significant change in renal indices between the two groups (p>0.05).

Conclusions: Etoricoxib was found to be significantly more effective than diclofenac on raising blood pressure of hypertensive patients. With respect to pulse rate and renal indices, the two drugs were not significantly different.