"Allowing these drugs to be purchased without a prescription, and without any advice or restrictions, sends a message to the public that they must be safe. The findings are a stark reminder that NSAIDs are not harmless. Diclofenac and ibuprofen, both commonly used drugs, were associated with significantly increased risk of cardiac arrest. NSAIDs should be used with caution and for a valid indication. They should probably be avoided in patients with cardiovascular disease or many cardiovascular risk factors," said Cardiology Professor Gunnar H. Gislason.
The results were published in the journal Cardiovascular Pharmacotherapy.
Previous studies show causal relationship between painkillers, heart risk
The recent Danish study is only one of the many research that established a link between NSAID-use and adverse cardiovascular incidents.
A study published in the British Medical Journal found a causal relationship between painkillers and heart failure risk among older patients. Researchers examined 10 million patients across Europe -- The Netherlands, U.K., Italy, and Germany -- aged 77 years and older and compared them with non-users. Research data showed that painkiller use was associated with a 19 percent increased risk of hospitalization due to heart failure. The risk of heart failure-related admission also varied with certain painkillers, which ranged between 16 percent for naproxen users and 83 percent for those who took ketorolac. Patients who took ibuprofen and diclofenac were also twice as likely to suffer heart failure. However the results were not significant to patients younger than 65 years old.
"This large observational study reinforces previous research showing that some NSAIDs, a group of drugs commonly taken by patients with joint problems, increase the risk of developing heart failure. It has been known for some years now that such drugs need to be used with caution in patients with, or at high risk of, heart disease," said Prof. Peter Weissberg, Medical Director at the British Heart Foundation.
"This applies mostly to those who take them on a daily basis rather than only occasionally. Since heart and joint problems often coexist, particularly in the elderly, this study serves as a reminder to doctors to consider carefully how they prescribe NSAIDs, and to patients that they should only take the lowest effective dose for the shortest possible time. They should discuss their treatment with their GP if they have any concerns," Prof. Weissberg added.
The BHF recommends that users take the lowest dose possible for the shortest period.
A 2013 study also showed that taking high doses of painkillers may raise the odds of suffering a heart attack by one-third. Ibuprofen users were also more than twice as likely to experience major coronary event, according to the study. The findings were published in the journal The Lancet.
Furthermore, a 2014 study revealed that NSAIDs were associated with increased odds of 30-day stroke mortality. Data published in the journal Neurology found that stroke-related deaths were 19 percent higher in patients who took painkillers compared with nonusers.
In light of various study results, the FDA has required drug manufacturers to indicate heart attack and stroke warnings on existing painkiller labels. The agency also called for label updates for over-the-counter NSAIDs.
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