A review of research has clarified the heart and stroke risks associated with taking anti-inflammatory drugs.
Australian and Canadian researchers have analyzed the risk of heart attack and stroke from commonly used non-steroidal anti-inflammatory drugs (NSAIDs) such as Nurofen and Voltaren, by reviewing a number of studies. Of the drugs investigated, naproxen and low-dose ibuprofen (Nurofen) are least likely to increase heart attack and stroke. Diclofenac (Voltaren), on the other hand, appears to increase risks even in doses available without a prescription.
The research was published in PLoS Medicine this week.
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Professor Richard Day is Professor of Clinical Pharmacology, St Vincent’s Hospital Clinical School and Pharmacology, School of Medical Sciences, Faculty of Medicine, University of New South Wales; Director Clinical Pharmacology & Toxicology, St Vincent’s Hospital, Sydney
“This is an important update on the risks for heart attack and stroke from the use of NSAIDs that pools the data from a large number of observational studies. The analyses confirm the concerns that have been emerging that even in the ‘over the counter’ use of these medicines, care should be taken, moreso if an individual is at known risk for cardiovascular disease. An hierarchy of risk is emerging – low-dose naproxen and ibuprofen are safer than diclofenac. The authors are cautious about celecoxib. The risks increase with increasing doses for all NSAIDs. The other side of the coin, the risk of bleeding and ulceration from the bowel needs to be considered in making decisions. Older individuals with any history of cardiovascular or gastrointestinal problems or risks, would be wise to consult with their GP.”
Note: Professor Richard Day sits on an advisory committee for ReckitBeniser that gives opinion about the proper use of ibuprofen.
Professor Patrick Ball is Foundation Professor of Rural Pharmacy, Associate Head, School of Biomedical Sciences & Discipline Leader in Pharmacy, Charles Sturt University, New South Wales
“We have known for a number of years that these medicines can raise blood pressure and put a strain on the heart, but what this paper gives us is a useful measure of the real risks. We must remember that being in pain can strain the heart too. The extra information this paper provides on which of the medicines in this group may be safer will help guide safe and effective use. People who know they have heart problems should always talk to their doctor or pharmacist before using these medicines.”