Updated on 6 June 2013
Study shows that non-steroidal anti-inflammatory drugs (NSAIDs) and painkillers like ibuprofen, diclofenac, and coxibs may cause severe heart problems
Singapore: Research conducted by the Clinical Trial Service Unit and Epidemiological Studies Unit at the Oxford University, revealed that high doses of painkillers pose patients a small but significant risk of dying from heart problems, including heart attacks, strokes and heart failure, after prolonged use. The study has been published in The Lancet.
The drugs, known as non-steroidal anti-inflammatory drugs (NSAIDs), include ibuprofen and diclofenac, and also newer medication called coxibs. They are usually used by people with arthritis and other forms of chronic pain. The largest-of-its-kind study highlighted that for every 1,000 people with a moderate risk of heart disease taking them for one year, three extra people would have an avoidable heart attack including one death.
The study pooled the findings from 639 trials involving over 353,000 people after numerous small trials showed a link between NSAIDs and heart side effects. The research found that for every 1,000 people with a moderate risk of heart disease having one year of treatment with high-dose diclofenac (150mg daily) or ibuprofen (2400 mg daily), about three would experience an avoidable heart attack, of which one would be fatal. The study found naproxen was the safest NSAID.
Study leader, professor Colin Baigent, of the Medical Research Council Clinical Trial Service Unit and Epidemiological Studies Unit at the Oxford University, said, "We're talking about really low risks. The extra risk of a heart attack is very small. But if patients are worried they could talk to their GP about it and they can consider if the risks, which are real but small, are worth it for them."
Professor Alan Silman of Arthritis Research UK, said that, "NSAIDs are a lifeline for many millions of people with arthritis, and when used appropriately can be extremely effective in relieving pain. General practitioners (GPs) are aware of the risks of NSAIDs, and there has been a marked reduction in the use of diclofenac and a switch to naproxen in recent years. For patients with arthritis, not smoking, a healthy diet and having their blood pressure checked regularly are more important factors in reducing the risk of a heart attack. We would advise people with arthritis who are taking NSAIDs not to be unduly concerned by these latest findings and to seek the advice of their GP."