Stroke Association response to the European Heart Journal paper on paracetamol, stroke and heart disease risk

Stroke Association response to the paper ‘Sodium-containing acetaminophen and cardiovascular outcomes in individuals with and without hypertension’ by Chao Zeng et al. Published in the European Heart Journal on Thursday 24 February 2022.

Dr Richard Francis, Head of Research at the Stroke Association said:

“Paracetamol in pill, capsule or oral suspension (bottled liquid) form doesn’t usually contain any salt, but the soluble, fizzy paracetamol that you add water to does. If you had the maximum daily dose of soluble paracetamol, your salt intake from that alone would be over the daily recommended limit. In this study, people who were prescribed soluble paracetamol had more strokes in the year after it had been prescribed than those who were prescribed capsule or tablet forms, regardless of whether they had a history of high blood pressure.

“We don’t know from this study why people were prescribed soluble paracetamol and we don’t have a comparison against people who don’t take paracetamol at all, so we don’t know how many of the more at risk groups’ strokes could have been increased by other risk factors. This means that we can’t really apply the findings from this study to broader groups of people.

“What we do know is that pill, capsule, and oral suspension (bottled liquid) forms of paracetamol don’t usually contain salt, so these findings shouldn’t be too concerning for people choosing these forms of over-the-counter paracetamol. People who have been prescribed salty, soluble paracetamol should have its salt content made clearer to them, try to reduce the salt content in the food they eat, work with their doctor to manage their blood pressure and try to switch to a type of paracetamol without salt.”