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Teachable Moment
Less Is More
June 2015

Nonsteroidal Anti-inflammatory Drug Use in a Patient With HypertensionA Teachable Moment

Author Affiliations
  • 1Division of Immunology, University of Iowa, Iowa City
  • 2Division of Nephrology, University of Iowa, Iowa City

Copyright 2015 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Restrictions Apply to Government Use.

JAMA Intern Med. 2015;175(6):892-893. doi:10.1001/jamainternmed.2015.0809

A man in his 60s with hypertension, hyperlipidemia, and knee osteoarthritis presented with fatigue, decreased exercise tolerance, and worsening bilateral leg swelling. For 5 years, he had been prescribed lisinopril, simvastatin, and meloxicam as needed for pain. Over the past 3 months, he had been taking meloxicam, 15 mg daily, for worsening knee pain following a minor fall that led to a persistent sense of discomfort that limited him from pursuing recreational activities like biking and running but did not otherwise prevent him from performing his activities of daily living. He had not tried acetaminophen or other pain relievers before. During this same time, his lisinopril dose was doubled to 20 mg daily because his blood pressure had been slowly rising.

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