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NSAIDs Risky for Heart Patients
Nonsteroidal anti-inflammatory drugs (NSAIDs ) include such common medicine cabinet mainstays as ibuprofen (Motrin, Advil) and naproxen (Aleve). Many of us pop a pill or two at least a few times a week to relieve headaches, joint pains, and muscle aches. Since they are so common and so inexpensive, it’s easy to assume that NSAIDs are safe. Yet frequent use of these drugs may cause ulcers, kidney failure, erectile dysfunction, and high blood pressure.
Cardiologists are especially concerned about the link between NSAIDs and heart disease. Congestive heart failure and heart arrhythmias have been tied to NSAID use. So have heart attacks. In a post last year, I reviewed a study of heart attack survivors that reported a 45 percent increase in second heart attacks amongst those who used NSAIDs. The risk was there whether the drugs had been used briefly or chronically.
Extending their work on NSAIDs and heart disease, Dr. Anne-Marie Schjerning and colleagues at Copenhagen University investigated just how long the risk of taking NSAIDs persisted after a heart attack. They also evaluated the effects of COX-2 inhibitors (including Celebrex and Vioxx). Nearly 100,000 Danish heart attack survivors were studied. Surprisingly, the likelihood of a second heart attack in NSAID and COX-2 users did not diminish over time. Instead, even five years out from the attack, those who used these drugs had a 63 percent greater risk of dying compared with those who didn’t take either type of drug.
Not all NSAIDs are alike, and diclofenac (Voltaren, Cataflam) seems to be the most risky, while naproxen is relatively safer. For some people, NSAIDs and COX-2s are the only effective way to deal with the pain of arthritis or other conditions. Stronger drugs, such as narcotics, may be too sedating, and acetaminophen (Tylenol) may not provide adequate relief. If that’s your situation, it’s important to check in with your doctor and see what other non-medical options may be available to help you manage your pain safely and effectively.
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