Just a week of painkiller use may up heart attack risk

Henrietta Strickland
May 13, 2017

So while the study shows that risk of a heart attack increases as soon as a few days into taking NSAIDs, the links may not be as clear as suggested, Evans said.

Overall the increase in risk of a heart attack is about 20 to 50% if using NSAIDs compared with not using these medications.

In order to determine the factors, time course, and risks of acute myocardial infarction associated with oral NSAIDs, researchers from McGill University, Montreal, Canada performed a systematic review and a one stage bayesian individual patient data meta-analysis.

Heart attack risks were higher for people on pain medications called non-steroidal anti-inflammatory drugs (NSAIDs).

Previous research has linked the use of NSAIDs to an increased risk of heart attack, but the timing of the risk, the effect of dose, treatment duration, and the comparative risks between different NSAIDs were poorly understood.

The study's authors were not able to exclude other factors that contribute to heart attacks, and some observers said the risks of NSAIDs are not definitive.

This "BMJ" report follows a study published in March in the European journal "Cardiovascular Pharmacotherapy", which showed that NSAID use was associated with heart-attack risk.

"Prescribers should consider weighing the risks and benefits of NSAIDs before instituting treatment, particularly for higher doses".

Past studies have found that common painkillers increase risk of cardiac arrest by up to a third.

"Where this study is useful is that if you're thinking about one drug over another, I wouldn't be too concerned about picking which one in terms of the ones that are available on the market because they seem to be fairly similar", Mamdani said. "But at a population level, it's important, and if people want to contribute to public health, they might wish to make more informed choices".

Also the drugs had not been proved to be a direct cause of heart attack.

Dr Mike Knapton of the British Heart Foundation, suggests patients and doctors weigh up the risks and benefits of taking high doses of these common painkillers, particularly if they have survived a heart attack or are at higher risk. Each year, it's estimated that 735,000 people in the United States have a heart attack. Vioxx was pulled from the USA market in 2004 because it increased the risk of heart attack and stroke. The risk was higher for people who took 1,200 mg a day of ibuprofen-the equivalent of six standard tablets of Advil-and 750 mg a day for naproxen, the equivalent of roughly three and a half standard Aleves.

And they say without an understanding of the baseline, it is then hard to judge the impact of any possible increase in risk. Experts say this does not mean everyone should stop taking medicine for aches, pains and fevers but people who are already at risk for a heart attack should be cautious.

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