HypertensionCohort study
Sodium-based paracetamol: impact on blood pressure, cardiovascular events, and all-cause mortality
- Retrospective cohort study
- linked electronic health records
- deep learning approach
Authors' conclusion
This study does not support previous suggestions of increased SBP and an elevated risk of cardiovascular events from short-term use of sodium bicarbonate paracetamol in routine clinical practice.
Study context
- Population
- UK individuals aged 60–90 years with at least one paracetamol prescription
- Participants
- 475,442 individuals
- Exposure
- Sodium-based vs non-sodium-based paracetamol
- Sodium-basedn = 14,462
- Non-sodium-basedn = 460,980reference
- Outcome
- SBP, major CV events (MI, HF, stroke) and all-cause mortality
- Follow-up
- Within 1 year after baseline
Main finding
As reported in the abstract
Relative risk
1.46
CI 1.40–1.52
Sodium-based vs Non-sodium-based
RR 1.46 (CI 1.40–1.52)
- No difference in systolic blood pressure (SBP)
- −0.04 (−0.51, 0.43) (mean difference, mmHg; 95% CI)
- No association with major CV events (RR)
- 1.03 (0.91, 1.16)
- All-cause mortality after further accounting for residual confounding: attenuated towards the null (RR)
- 1.08 (1.01, 1.16)
Observational data: associations, not effects.
Further findings
Sources of confounding for mortality association (exploratory)
- Dysphagia and related conditions were major sources of uncontrolled confounding by indication
Original publication
Sodium-based paracetamol: impact on blood pressure, cardiovascular events, and all-cause mortality. Eur Heart J. Published 23 August 2023. doi:10.1093/eurheartj/ehad535
Summarised from the published abstract; every number is checked against it