Don’t use non-steroid anti-inflammatory drugs (NSAID) in subjects with arterial hypertension, heart failure, renal insufficiency from any cause, including diabetes.

Type of practice


NSAID are largely used for muscle, bone and joint pain, but are associated with important cardiovascular, renal and haematological adverse effects, mainly in elderly people. They may determine a blunted response to the antihypertensive drugs, water retention and worsening of the renal function in patients with high blood pressure, heart failure and chronic kidney disease from any cause, including diabetes. The most recent guidelines recommend to limit NSAID for the pain control in patients affected by such diseases, and to prefer paracetamol, tramadol and short-lived oppioids as an alternative, as far as possible.


4. Whittle SL, Colebatch AN, Buchbinder R, et al. Multinational evidence-based recommendations for pain management by pharmacotherapy in inflammatory arthritis: integrating systematic literature research and expert opinion of a board panel of rheumatologists in the 3e Initiative. Rheumatology 2012; 51: 1416-1425.

Attention. Please note that these items are provided only for information and are not intended as a substitute for consultation with a clinician. Patients with any specific questions about the items on this list or their individual situation should consult their clinician.