Acetaminophen is one of the most widely used analgesic drugs today. It is judged safe by the scientific community at large, but is also one of the most commonly overdosed drugs and the most common cause for drug‐induced hepatic failure.

In order to challenge the results of recent studies that have suggested a relationship between therapeutic dosage of acetaminophen and increased risk of adverse events and mortality, researchers conducted a prospective study using data from 5,429 participants in the Impact of Educational and Professional Supportive Interventions on Nursing Home Quality Indicators project (IQUARE), a multicenter, individually tailored, nonrandomized controlled trial in NHs in southwestern France.

Overall, the researchers observed no associations between acetaminophen use and the risk of mortality or myocardial infarction. However, in one of the group’s models, acetaminophen use was associated with a significantly increased risk of stroke in patients with diabetes (hazard ratio 3.19).

Diabetes mellitus affects the vascular system by increasing arteriosclerosis, remodeling vessels with a decrease of lumen, diminishing capillary density, and increasing vessel leakage. Chronic inflammation, endothelial dysfunction, and hypercoagulability result in macrovascular complications, such as strokes.3

Moreover, type 2 diabetes, more prominent in older subjects, is responsible for nonalcoholic fatty liver disease, with a prevalence in 70% of patients.3

Diminished PG synthesis from acetaminophen intake could result in diminished vasodilation and favored platelet aggregation. Acetaminophen is also known to decrease glutathione levels, resulting in increased inflammation.3 Adding to that, chronic use may affect an already diminished liver function.

Acetaminophen, in older diabetic patients, could become a triggering factor for strokes.

To read the full study, please click HERE.