Long-Term Painkillers Increase Risk Of Heart Attack

A recently published study has shown that people who take simple painkillers such as ibuprofen or diclofenac for long-term pain relief, have a greater risk of having a heart attack, stroke or dying from such an event. People who smoke or are obese are particularly at risk when it comes to this.

These pain relieving drugs known as non-steroidal anti-inflammatory drugs — or NSAIDs for short — are used by millions of people worldwide for relieving their long-term pain from several different things, such as from conditions like arthritis.

What is this study all about?

The study analyzed data from 280 studies which compared NSAIDs with a placebo given to two groups of participants.  They also analyzed 474 trials comparing ibuprofen and diclofenac (both of which are NSAIDs). The data was gathered from over 30,000 people and it recorded the number of cases of heart attack, stroke, cardiovascular events, death, and bleeding from the digestive tract (a common side effect of taking NSAIDs).

How much of a link between NSAIDs and cardiovascular events was found?

The study showed that for every 1000 people who took one of the painkilling drugs for a whole year, an additional three would have a serious health event related to a blockage of a blood vessel, either in their heart or their brain for example, a heart attack or stroke. (This was compared to patients in the control group who were treated with the placebo). Of these three people, one of them would die as a result of this event. 

When it comes to the the general population, the risk of this type of event is about 8 in 1000 people, so in the population of people studied in this particular study it would be an additional three, making it a total of 11 people in 1000.

All of the NSAIDs studied were found to double the risk of heart failure in patients.

One good finding in this study was that the NSAID which is called naproxen was actually not associated with any of the increased risk factors for cardiovascular events or related deaths. This means that if you must take an NSAID, naproxen is a good choice for you. Also, although there were more side effects and deaths in the ibuprofen-treated people, this did not reach a statistically significant level.  This means that it did not happen often enough to be taken as proof - it could just have occurred by chance, for other reasons.

Is the cardiovascular connection completely unexpected?

No. It has been known for some time that NSAIDs may bring on untoward health events because of their negative effects on blood vessels. In 2004 there was a worldwide voluntary withdrawal by the manufacturer (Merck, Sharp and Dohme) of their product Vioxx and Vioxx Acute (rofecoxib) and in 2005 the FDA asked Pfizer to withdraw its prescription NSAID, Bextra (valdecoxib).