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Emerging therapies in the management of hypertensive patients with osteoarthritis

Giorgio Gentile, Fabio Angeli, Giovanni Mazzotta, Gianpaolo Reboldi , Paolo Verdecchia

Osteoarthritis (OA) constitutes one of the leading causes of pain and disability worldwide. The incidence of OA will likely rise over the next few decades, with a significant impact on healthcare costs. Patients with OA are often affected by a number of cardiovascular comorbidities, including hypertension, which is present in approximately 40% of cases. Cyclooxygenase (COX) inhibitors, both nonselective and selective COX-2 inhibitors, are often used to control pain in these patients. Unfortunately, such drugs may cause a variable degree of blood pressure increase. Because even small increases in blood pressure values may lead to a significant increase in the risk of major cardiovascular events and death, the consequent healthcare concerns have led to the development of the COX-inhibiting nitric oxide donator class of drugs. These new drugs are aimed to improve cardiovascular and gastrointestinal safety profiles, as compared with nonsteroidal anti-inflammatory drugs, through the release of nitric oxide.