Retrospective comparison of cardiac and renal effects between celecoxib and rofecoxib in older hypertensive patients
Year: 2003
Type: article
Study design: Observational Study
Abstract: COX-2-specific inhibitors (coxibs) may have adverse cardiac and renal effects on older patients with hypertension. PPRNet, a research network of ambulatory care practices that share a common electronic medical record, offered an ideal usual-practice setting for comparing outcomes in hypertensive patients treated with celecoxib or rofecoxib. Using a retrospective design, stable hypertensive patients 55 years and older were identified from 31 ambulatory care practices. Patients were included if they were prescribed a coxib between 7/1/1999 and 6/30/2000. Patients prescribed a nonspecific non-steroidal anti-inflammatory drug (NSAID) in the 3-month period prior to the coxib index date were excluded, as were patients with a history of congestive heart failure. Patients prescribed an NSAID or additional coxib after the coxib index date were not excluded from the analyses; however blood pressure (BP) measurements for such patients were censored after the initiation of these new medications. Outcomes were compared between celecoxib and rofecoxib patients using linear and logistic regression models, which all adjusted for age, sex, baseline comorbid conditions, baseline current anti-hypertensive medications, and certain model-specific baseline measures. Baseline characteristics of patients receiving celecoxib (n = 517) and rofecoxib (n = 443) were similar. No significant difference was observed in the proportion of patients whose systolic BP increased 20 mm Hg, whose diastolic BP increased 15 mm Hg, or who were prescribed a new anti-hypertensive medication. Patients on rofecoxib were significantly more likely (odds ratio = 1.68, 95% confidence interval = [1.09 - 2.60]) to have had their anti-hypertensive medication dose increased than patients on celecoxib, and this increase occurred sooner (p < 0.05) than with patients receiving celecoxib. New onset comorbidity, number of physician visits, and changes in body weight and laboratory values were similar across groups. Cardiac and renal outcomes between celecoxib and rofecoxib patients were comparable. However, significantly more rofecoxib- than celecoxib-treated patients had the dosage increased for their existing antihypertensive medication. When treating older hypertensive patients with coxibs, blood pressure should be monitored regularly.
Source: American Journal of Hypertension
Author: P NIETERT
Institution: Medical University of South Carolina
Language: English
Subfield: Pharmacology
Field: Medicine
Domain: Health Sciences
Open Access status: bronze
OpenAlex ID: W2004055683