Evaluation of Blood Pressure and Heart Rate in Patients with Hypertension Who Received Tapentadol Extended Release for Chronic Pain: A Post Hoc, Pooled Data Analysis

BACKGROUND AND OBJECTIVES: Hypertension is one of the most common co-existing conditions in patients with chronic pain, and the potential effects of an analgesic on heart rate and blood pressure are of particular concern for patients with hypertension. The purpose of this analysis was to evaluate changes in blood pressure and heart rate with tapentadol extended release (ER) treatment in patients with hypertension. METHODS: We performed a post hoc analysis of data pooled from three randomized, placebo- and active-controlled, phase III studies of tapentadol ER for managing chronic osteoarthritis knee (NCT00421928, NCT00486811) or low back (NCT00449176) pain (15-week, double-blind treatment period). Data were independently analyzed for patients with a listed medical history of hypertension at baseline and patients with at least one listed concomitant antihypertensive medication at baseline. Heart rate, systolic blood pressure (SBP), and diastolic blood pressure (DBP) were measured at each visit. RESULTS: In patients with a listed medical history of hypertension (n = 1,464), least-squares mean (LSM [standard error (SE)]) changes from baseline to endpoint with placebo, tapentadol ER, and oxycodone HCl controlled release (CR), respectively, were −0.7 (0.44), 0.2 (0.43), and −0.9 (0.45) beats per minute (bpm) for heart rate; −2.4 (0.64), −2.7 (0.64), and −3.7 (0.67) mmHg for SBP; and −1.0 (0.39), −1.3 (0.39), and −2.3 (0.41) mmHg for DBP; in patients with at least one listed concomitant antihypertensive medication (n = 1,376), the LSM (SE) changes from baseline to endpoint were −0.6 (0.45), 0.1 (0.44), and −0.7 (0.47) bpm for heart rate; −1.8 (0.66), −3.3 (0.65), and −3.7 (0.69) mmHg for SBP; and −0.7 (0.40), −1.4 (0.40), and −2.3 (0.42) mmHg for DBP. CONCLUSION: No clinically meaningful mean changes in heart rate or blood pressure were observed for the evaluated cohorts of patients with hypertension who were treated with tapentadol ER (100–250 mg twice daily).