A new study has suggested that the salt used as a 'hidden' ingredient in certain types of paracetamol could increase the risk of heart disease and death. Researchers warn that soluble pain relief medication often contains sodium to help tablets dissolve, but many patients are unaware of this, potentially exceeding the recommended daily salt intake of 2g.
The analysis, published in the European Heart Journal, looked at data from 790 British GP surgeries between 2000 and 2017. It involved approximately 300,000 patients aged 60 to 90, half of whom had high blood pressure. Among those with high blood pressure, the risk of developing heart failure or stroke was 5.6% for those taking sodium-containing paracetamol, compared with 4.6% for those on sodium-free versions.
For patients without high blood pressure, the risk of heart disease was also higher: 4.4% for those taking paracetamol with salt versus 3.7% for those without. Some soluble paracetamol tablets contain up to 0.44g of salt, meaning patients could exceed the daily limit through medication alone. The study also found that the chance of death during the follow-up period was greater for those taking the salt-containing drug.
Professor Chao Zeng, who led the study from Central South University in China, said doctors should prescribe salt-less versions where possible. Two academics from Australia's George Institute for Global Health called for mandatory front-of-pack warning labels on all medications containing significant sodium. However, Professor Sir Nilesh Samani from the British Heart Foundation noted the study's limitations, including a lack of data on dietary salt intake, and stressed that observational studies can only show association, not prove cause and effect.
