Common over-the-counter pain relievers can be an unexpected source of too much sodium

Soluble painkillers might provide quick relief, but researchers warn that many of them also contain a hidden and hearty dose of salt.

For every half gram of paracetamol or acetaminophen in a dissolvable tablet, you can also swallow about 0.4 grams of sodium, one of the main components of salt.

Sodium is often added to drugs to help them disintegrate in water; this allows the body to absorb the drug faster than swallowing a pill. But if the maximum daily dose of soluble paracetamol is taken, a person can easily exceed the recommended two grams of salt in the diet per day.

Even for those without high blood pressure, a population-based study in the UK suggests that any excess sodium can have adverse effects on the body, particularly on the cardiovascular system.

The research aimed to mimic a randomized controlled trial by comparing the health data of almost 300,000 adults over the age of 60, some of whom had high blood pressure and some of whom did not, but who were all recently prescribed paracetamol by their doctor. .

Compared to patients who were prescribed painkillers without sodium, the authors found that those who took paracetamol daily with sodium had a slightly but significantly higher risk of heart attack, stroke, heart failure, and heart failure. death a year later.

Without looking more closely at individual patients, it’s unclear to what extent high salt intake might impact these results, but numerous studies have shown a link between sodium levels and cardiovascular disease in sufferers. of arterial hypertension.

What’s interesting about the results of the current study, however, is that people with high and normal blood pressure had a similar risk of heart problems when extra salt was added to their daily diet.

The actual risk was only increased by about a percentage compared to those taking sodium-free medications, but at the population level it is still significant.

Further testing will be needed to determine if this extra dose of sodium ultimately caused an increase in blood pressure, thereby affecting heart health. Previous studies investigating the impact of sodium-infused drugs on blood pressure have produced inconclusive results.

In the meantime, the researchers warn physicians and patients to be aware that certain medications may exceed sodium intake recommendations.

“People should pay attention not only to the salt intake in their diet, but also not to neglect the hidden salt intake of medicines in their cabinet,” says Chao Zeng of Xiangya Hospital of Central University. South in China.

“Although the United States Food and Drug Administration requires all over-the-counter medications to list sodium content, no warnings have been issued regarding the potentially harmful effect of sodium-containing paracetamol on the risk of hypertension. , cardiovascular disease and death. The results suggest reviewing the safety profile of effervescent and soluble paracetamol.”

Fortunately, there are some forms of soluble paracetamol available that are made without sodium, or only in small amounts. These are great alternatives for those looking for the quick effects of effervescent medicine without the possible downsides of long-term use.

In light of the new findings, an editorial, published alongside the current study, urges suppliers to ensure that common painkillers do not cause undue harm to unsuspecting consumers.

“There is an immediate need for consumer protection against these risks,” write the authors of the editorial.

“Probably the most plausible and effective strategy is mandatory labeling of all drugs containing significant amounts of sodium with a front-of-pack warning label. [..] Information programs that raise awareness of the public and practitioners about hidden sodium in drugs and education about the need to avoid effervescent, dispersible, and soluble drugs in all but essential circumstances should also be considered. »

The study was published in the European journal of the heart (link not yet online at time of publication).

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