MONTREAL, Canada, Thursday May 25, 2017 – The use of even low doses of common painkillers known as NSAIDs – nonsteroidal anti-inflammatory drugs – has been linked to an increased risk of heart attack, a new Canadian study has found.
The scientists calculated that the likelihood of experiencing a heart attack increased by an average of 20 percent to 50 percent, compared with someone not taking the drugs, regardless of the dosage and amount of times the medications were taken.
The group of drugs under review included ibuprofen, naproxen, diclofenac and celecoxib, which are available over-the-counter or by prescription for higher doses, for the relief of pain or fever resulting from such causes as headaches, influenza, back pain and menstrual cramps.
“We found that all common NSAIDs shared a heightened risk of heart attack,” said Dr Michèle Bally, an epidemiologist at the University of Montreal Hospital Research Centre, who led the research.
“There is a perception that naproxen has the lowest cardiovascular risk (among the NSAIDs), but that’s not true.”
The overall finding was that taking any dosage of these drugs for one week, one month or longer was linked to an increased risk of a heart attack.
The risk appeared to decline when these painkillers were no longer taken, with a slight decline one to 30 days after use and a greater decline – falling below 11 percent – between 30 days and one year after use.
Previous research has showed that this class of painkillers could increase the risk of having a heart attack, known as myocardial infarction.
In 2015, the US Food and Drug Administration called on drug makers to update their warnings labels to identify an increased risk of a heart attack or stroke.
The specifics in terms of timing, dosage and treatment durations were nevertheless less clear.
For the study, Bally and her team reviewed all available studies in this area from Canadian and European databases, analysing the findings from 446,763 people, with 61,460 of them having had a heart attack. Their goal was to calculate the risk, determinants and time course of heart attacks associated with the use of NSAIDs under typical circumstances.
Based on their findings, which were published in the BMJ, Bally’s team suggested that doctors and patients weigh the potential harms and benefits before relying on the drugs as a treatment option.
“People minimize the risks because drugs are over the counter and they don’t read labels,” Bally said. “Why not consider all treatment options? … Every therapeutic decision is a balance of benefits and risk.”
Noting that millions of these pills are sold every year, Bally said: “Therefore the risk, no matter how small or relative, is important to note from a population viewpoint.”
The researchers nevertheless stressed that the findings of the study were purely observational, as they used readily available data about certain populations. Not all potentially influential factors could be taken into account, they said.