Non-steroidal anti-inflammatory drugs (NSAIDs) include ibuprofen, naproxen, and diclofenac. They also include the COX-2 inhibitors such as celecoxib. These medications are seen in products under the brand name Motrin, Aleve, Voltaren, and Celebrex respectively. These classes of medications are extremely popular as they help consumers treat a variety of ailments including helping to relieve pain, inflammation and lower fever. Moreover they are inexpensive and many, such as ibuprofen and naproxen, do not require a prescription at the lower doses.
However their chronic use has been linked to serious medical complications such as ulcers, kidney failure and cardiac issues. In March, a study published in the March issue of European Heart Journal – Cardiovascular Pharmacotherapy found NSAID use (specifically Ibuprofen and diclofenac) to increase of cardiac arrest.
This week a new study published in the BMJ, British Medical Journal, found increase risk of heart attack in those who took ibuprofen or naproxen. In this study the team reviewed records of 460,000 patients, 61,000 of them who suffered a heart attack, and found the higher the dose of NSAID, the higher the risk. They studied celecoxib, naproxen, ibuprofen and diclofenac and with merely a month of daily use of any of these medications, a 24-58 percent increase risk in heart attack was seen. Although this sounds high, the absolute risk is still small and this was an observational study rather than a study that tested cause and effect.
Study author, Dr. Michele Bally, stated, “These numbers do not mean that a person has a 20 to 50 percent risk of having a heart attack after taking those drugs”, but she suggested, “If someone needs to treat occasional pain, fever, or inflammation they should consider all available treatment alternatives and get the help of the health care providers.”
Why would NSAIDS cause heart attack?
One theory is the medication may cause suppression of prostacyclin, a cardioprotective lipid (prostaglandin), that inhibits platelet activation and vasoldilation (relaxation of the blood vessels). NSAIDS have also been known to raise blood pressure, possibly by this inhibition of vasodialation. This type of stress on a heart, especially if its vulnerable to abnormal heart rhythms or heart disease, can cause cardiac arrest.
But we don’t want to be fearful that taking antiinflammatories will stop our hearts. Being proactive with our heart health is paramount, and this study reminds us to use caution with over the counter medications.
Preventing Heart Disease
Firstly, we must know our risk factors. These include:
Family history of heart disease
Personal history of heart disease
High Blood Pressure
Males over 40
Females who are post menopausal
and even short stature has been cited as a potential risk factor.
As you can see, many of us can be at risk for heart disease. Therefore secondly, we should be evaluated with an EKG, echocardiogram and any other exams our medical provider and/or cardiologist deem necessary.
Thirdly, reduce your risk by the following:
Maintain a normal blood pressure
Maintain normal blood sugar
Maintain normal cholesterol and lipid levels
Maintain a balanced diet, rich in potassium-rich foods such as fruits and vegetables
Maintain a healthy weight.