Routinely taking common painkillers, including ibuprofen, could put
people at a heightened risk of heart attack, new research has found.
Experts have drawn a link between taking non-steroidal anti-inflammatory
drugs (NSAIDs), which are used to treat pain and inflammation, and an increased
risk of heart attacks.
Doctors should consider the “risks and benefits” before dishing out the
commonly prescribed drugs, particularly at higher doses, the authors cautioned.
Researchers from Canada, Finland and Germany conducted an analysis of
previous studies, which held data on almost 450,000 people - 61,460 of whom had
suffered a heart attack.
They found that taking any dose
of NSAIDs, including ibuprofen and naproxen, for one week, one month, or more
than a month was associated with an increased risk of myocardial infarction
(heart attack), according to the study published in The BMJ (British MedicalJournal).
They said there was a “a rapid onset of risk” for
heart attack within the first week of use, while risk was highest during the
first month of taking the painkillers.
Using the drugs for longer than one month did not
increase risk more than with shorter use, the researchers found.
Risk was higher among users on high doses of the
painkillers.
Use for between eight and 30 days at a high dose was
“particularly harmful” when people were taking more than 1,200mg a day of
ibuprofen, 750mg a day of naproxen and more than 25mg a day of rofecoxib, they
wrote.
Overall, the increased risk of suffering a heart
attack was between 24% and 58% if taking celecoxib, ibuprofen, diclofenac,
naproxen and rofecoxib, compared with not using these medications.
While the authors stressed that
conclusions should not be drawn about cause and effect, they wrote: “Compared
with non-use of NSAIDs in the preceding year, we documented that current use of
all studied NSAIDs, including naproxen, was associated with an increased risk
of acute myocardial infarction.
“Given that the onset of risk of acute myocardial
infarction occurred in the first week and appeared greatest in the first month
of treatment with higher doses, prescribers should consider weighing the risks
and benefits of NSAIDs before instituting treatment, particularly for higher
doses.”
Dr Mike Knapton, associate medical director at the
British Heart Foundation, said: “This large-scale study worryingly highlights
just how quickly you become at risk of having a heart attack after starting
NSAIDs.
“Whether you are being prescribed painkillers like
ibuprofen, or buying them over the counter, people must be made aware of the
risk and alternative medication should be considered where appropriate.”
John Smith, chief executive of
the Proprietary Association of Great Britain, the UK trade association
representing manufacturers of branded over-the-counter medicines, said: “NSAIDs
that are available to buy over the counter are much lower doses than those
prescribed.
“Prescribed NSAIDs are also typically used daily and
for much longer duration, often to treat long-term conditions.
“People taking over-the-counter NSAIDs should not be
concerned by this research if they are taking the medicine occasionally for
short periods and according to the on-pack instructions.”
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