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May 11, 2017

Common painkillers linked to heart attack risk

If you regularly use over-the-counter pain relievers such as ibuprofen or naproxen, listen up: researchers from the University of Montreal Hospital Research Center have discovered a link between the use of these medications and an increased risk of suffering a heart attack.

In a study published this week in the British Medical Journal (BMJ), a team of doctors led by epidemiologist Dr. Michele Bally found that using common pain relief medications known as nonsteroidal anti-inflammatory drugs (NSAIDs), regardless of dosage, could increase the risk that a person will experience a heart attack by up to 50% on average.

While the authors did not find evidence suggesting that NSAIDs were responsible for causing heart attacks, Dr. Bally told CNN that their observations indicate that “all common NSAIDs” were linked to the increased risk of heart attack, including ibuprofen diclofenac, celecoxib, and even naproxen, despite the “perception” that it “has the lowest cardiovascular risk.”

As the website explains, these medications (which are available both over the counter and by prescription, in stronger doses) are typically used to relieve pain and/or fever when used over a short period of time. However, the study found that even one week of regular use, even at over-the-counter strength, was enough to increase the risk of a heart attack.

Use caution, even with over-the-counter pain killers, experts warn

Dr. Bally, along with colleagues from Canada, Finland and the UK, recruited nearly 447,000 men and women, including 61,460 who had previously suffered a heart attack (acute myocardial infarction), and evaluated the impact of taking any regular doses of NSAIDs for one week, one month and for more than one month, according to CBS News.

On average, they observed a 20 percent to 50 percent increase in the risk of any of the patients suffering a heart attack, and found that the greatest risk occurred when individuals used a high daily dosage of NSAID (1200 mg of ibuprofen, 750 mg of naproxen, 200 mg of celecoxib, 100 mg of diclofenac) during the first month of treatment.

The researchers emphasize that the overall risk is very small, will vary based on the individual’s baseline, and appeared to decline once use of the anti-inflammatory medication ceases. A slight decline was observed one to 30 days after termination of NSAID use, CNN noted, and a decline of 11 percent was found between 30 days and one year following use of the pain killers.

“I think this study is another cautionary tale to be very careful before using these drugs and not be lulled into a place of complacency just because they're over the counter,” Dr. Deepak Bhatt, executive director of the Brigham and Women's Hospital interventional cardiovascular program, told CBS News. “If someone has to use an NSAID for pain relief, the best advice is to use the lowest possible dose and for shortest amount of time possible."

“Other studies show that NSAIDs can raise blood pressure and lead to fluid retention. These sorts of things can help precipitate a heart attack, particularly in people who are already vulnerable to it,” Dr. Bhatt added. “The bottom line is, don't treat these drugs like candy just because they're sold over the counter. Treat them like any medications. Only use them if you really need to, lowest dose possible, for least amount of time.”

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