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Effects of Celecoxib and Diclofenac on Blood Pressure, Renal Function, and Vasoactive Prostanoids in Young and Elderly Subjects
Author(s) -
Dilger Karin,
Herrlinger Charlotte,
Peters Jörg,
Seyberth Hannsjörg W.,
Schweer Horst,
Klotz Ulrich
Publication year - 2002
Publication title -
the journal of clinical pharmacology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.92
H-Index - 116
eISSN - 1552-4604
pISSN - 0091-2700
DOI - 10.1177/009127000204200905
Subject(s) - blood pressure , celecoxib , diclofenac , medicine , plasma renin activity , renal function , mean arterial pressure , aldosterone , endocrinology , cyclooxygenase , renin–angiotensin system , pharmacology , heart rate , chemistry , biochemistry , enzyme
Cyclooxygenase (COX) inhibitors are among the most widely used drugs, especially in the elderly. It has been claimed that the new COX‐2 inhibitors offer advantages in terms of drug safety. To test this hypothesis, the authors compared in a double‐blind, randomized trial the effects of celecoxib (200 mg bid) and diclofenac (75 mg bid) on blood pressure and renal function in two groups (each n =12) of young (mean age = 32 years) and elderly (mean age = 68 years) normotensive subjects. Changes from baseline in the 24‐hour blood pressure profiles, parameters of the renin‐angiotensin‐aldosterone system, inulin clearance, urinary marker proteins, and eicosanoid excretion were monitored during the treatment period of 2 weeks. Comparison between celecoxib and diclofenac showed no significant difference in minor alterations of blood pressure. During daytime, there was a trend to elevation of mean arterial blood pressure (mmHg) by celecoxib in the elderly of 2.8 (95% confidence interval [Cl] = −2.5 to 8.2) in comparison with the young subjects of −1.3 (95% Cl = −3.7 to 1.0); there was also a trend to elevation of mean arterial blood pressure by diclofenac in the elderly of 4.1 (95% Cl = −1.2 to 9.4) in comparison with the young subjects of 0.4 (95% Cl =−2.4 to 3.2). In both populations, the authors found no significant drug effects on the parameters of the renin‐angiotensin‐aldosterone system, inulin clearance, and urinaiy marker proteins. As expected, diclofenac reduced excretion of all prostanoids, whereas celecoxib did not affect production of TxB 2 and its metabolites. Neither in young nor in elderly normotensive subjects were blood pressure and renal function significantly affected by a short‐terrn treatment with standard doses of celecoxib and diclofenac. Therefore, normal aging appears not to represent a special risk factor in therapy with these two agents.