Minimizing cardiovascular complications during the treatment of osteoarthritis

Andrew Whelton, Allan Gibofsky

Research output: Contribution to journalArticlepeer-review

1 Scopus citations


Individuals with osteoarthritis face an increased risk of cardiovascular (CV) disease compared with age-matched control subjects. Both conditions share some common risk factors (eg, age, obesity, and hypertension) and the consequences or treatment of osteoarthritis may increase CV risk by impairing physical activity and exacerbating CV risk factors. Nonsteroidal anti-inflammatory drugs may have prothrombotic and/or hypertensive effects and a negative impact on renal function, all of which contribute to the increased risk of CV disease associated with these agents. The magnitude of these effects differs between agents and is, in part, determined by the relative balance of cyclo-oxygenase-1 or cyclo-oxygenase-2 inhibition. To minimize risk of CV disease in patients with osteoarthritis taking nonsteroidal anti-inflammatory drugs, physicians need to 1) monitor blood pressure and the new appearance or exacerbation of edema; 2) encourage lifestyle changes/nonpharmacologic treatments for pain/risk factor management; 3) choose the lowest effective dose of appropriate drug therapy to achieve adequate pain relief while minimizing CV risk; 4) change nonsteroidal anti-inflammatory drugs as needed to one with lower propensity to aggravate CV risk; and 5) modulate antihypertensive therapy and diuretic management as needed to maintain target blood pressure and weight.

Original languageEnglish (US)
Pages (from-to)466-476
Number of pages11
JournalAmerican Journal of Therapeutics
Issue number6
StatePublished - Nov 2011


  • blood pressure
  • cardiovascular disease
  • NSAIDs
  • osteoarthritis
  • risk factors

ASJC Scopus subject areas

  • Pharmacology
  • Pharmacology (medical)


Dive into the research topics of 'Minimizing cardiovascular complications during the treatment of osteoarthritis'. Together they form a unique fingerprint.

Cite this