‘Painkillers can cause heart attacks’
Popping painkillers can be harmful. A new research revealed that higher-dose use of some non-steroidal anti-inflammatory drugs (NSAIDs) increases major vascular events like non-fatal heart attacks, strokes and even lead to death.
NSAIDs are used in managing pain in people with inflammatory disorders like rheumatoid arthritis, and are some of the most commonly used drugs worldwide. Earlier research has linked their use with an increased risk of serious gastrointestinal complications. However, the new generation of NSAIDs (coxibs) developed to reduce these gastrointestinal side effects have now come under scrutiny for increasing the risk of heart attacks and death.
The new study published in British medical journal the Lancet shows that higher dose regimens of older NSAIDs, such as diclofenac 150mg and ibuprofen 2400mg daily, are associated with similar risks of heart disease. As such, for every 1000 individuals with a moderate risk of heart disease allocated to 1 year of treatment with high-dose diclofenac or ibuprofen, about three would experience an avoidable heart attack, of which one would be fatal. In addition, the research revealed that all NSAIDs double the risk of heart failure and produce a 2–4 times increased risk of serious upper gastrointestinal complications such as bleeding ulcers. The meta-analysis of patient data from 639 randomised trials shows that the size of these risks can be predicted, which may help physicians decide which types of patient are best suited to which NSAID regimen. “Importantly, the increased risk of heart attacks from individual NSAIDs seemed to be proportional to a patient’s underlying risk of such heart attacks, so that the risk is highest in those with a previous history of heart disease or those with cardiac risk factors such as raised blood pressure or cholesterol,” said the Lancet.
According to lead author Professor Colin Baigent from the Clinical Trial Service Unit and Epidemiological Studies Unit, University of Oxford, UK, “Whilst NSAIDs increase vascular and gastrointestinal risks to a varying extent, our analyses indicate that the effects of different regimens in particular patients can be predicted, which may help physicians choosing between alternative NSAID regimens to weigh up which type of NSAID is safest in different patients.” Writing in a linked Comment, Marie Griffin from Vanderbilt University Medical Centre in the USA says, “Identification of safe and effective strategies for chronic pain is sorely needed.”
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