People who have high blood pressure who take paracetamol on prescription could increase their risk of heart attacks and strokes. This was revealed by a study.
Doctors are supposed to think about the risks and benefits for patients who take it over many months, the University of Edinburgh researchers said.
Taking the painkiller for headaches and fevers is safe, and it stresses the body.
Other experts believe that more people need to be studied over a longer period of time to confirm the findings.
Paracetamol is widely used around the world as a short-term remedy for aches and pains but is also prescribed to manage chronic pain, despite little evidence of its benefit for long-term use.
Half a million people, or one out of every 10 people, in Scotland had been prescribed painkillers in 2018.
High blood pressure affects one out of every three people in the United Kingdom.
The study tracked 110 volunteers, two-thirds of whom had been taking drugs for high blood pressure or hypertension.
For a randomised trial, they asked them to take a gram of paracetamol four times a day for two weeks (which is a common dose for patients who have chronic pain) and then a placebo or dummy pill for another two weeks.
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The trial showed that paracetamol increases blood pressure.
Edinburgh clinical pharmacologist, Prof James Dear, said that “one of the most important risk factors for heart attacks and strokes is much more than placebo.”
The researchers advised doctors to start with patients with chronic pain on as low a dose of paracetamol as possible and keep a close eye on those who have high blood pressure and a risk of heart disease.
Lead investigator, Dr Iain MacIntyre, clinical pharmacology consultant for NHS Lothian, said:
“This is not about short-term use of paracetamol for headaches or fever, which, of course, is fine.”