92.163 Study identifies hospitalizations for heart failure among a group of nearly 10 million NSAID users in the UK, Netherlands, Italy and Germany, who began treatment between 2000 and 2010
common analgesics used by millions of people in the UK are linked to an increased risk of heart failure, experts have said.
nonselective nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen may increase the risk of being admitted to hospital with heart trouble, according to a study.
Previous studies have linked the drugs to abnormal heart rhythm – which can cause heart failure – and an increased risk of heart attack and stroke if taken regularly
Drugs – along with a sub-group of anti-inflammatory drugs known as selective COX-2 inhibitors – used to control pain and inflammation and are commonly taken by people with arthritis
The new study, published in British Medical Journal ( BMJ ), used data from nearly 10 million NSAID users in the United Kingdom, the Netherlands, Italy and Germany, NSAIDs started treatment between 2000 and 2010.
Generally, 92.163 hospitalizations were identified for heart failure in the group.
The study found that people who had taken any NSAIDs in the previous 14 days was 19 percent higher risk of hospitalization for heart failure compared with people who had used NSAIDs at any time in the past.
The risk of hospitalization for heart failure increased over seven traditional NSAIDs (diclofenac, ibuprofen, indomethacin, ketorolac, naproxen, nimesulide and piroxicam) and two COX-2 inhibitors (etoricoxib and rofecoxib).
Increased risk of hospitalization ranged from 16 percent for naproxen to 83 percent of ketorolac.
The researchers also found that the risk of heart failure doubled to diclofenac, etoricoxib, indomethacin, piroxicam and rofecoxib is used in very high doses, although it stressed this should be interpreted with caution.
Even the average doses of indomethacin and etoricoxib was associated with increased risk, the study found, but there was no evidence that celecoxib increases the risk of hospitalization for heart failure at doses commonly used.
Experts said the study “provides further evidence that traditional individual NSAIDs frequently used and COX-2 inhibitor are associated with an increased risk of hospitalization for heart failure. In addition, the risk appears to vary between drugs and according to the dose. ”
In an accompanying editorial, two researchers from the Danish health officials said that due to the widespread use of NSAIDs, “even a small increase in cardiovascular risk is a concern for public health.”
They said the fact that can be bought over the counter in supermarkets “further fuels the misconception that NSAIDs are safe drugs that are safe for everyone.”
Professor Peter Weissberg, medical director of the British Heart Foundation, said: “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 years that these drugs should be used with caution in patients with or at high risk of heart disease. This applies especially to those who take daily and not just occasionally.
“From the heart and joints problems often coexist, particularly in the elderly, this study serves as a reminder to physicians to carefully consider how prescribing NSAIDs, and patients should only take the minimum dose effective for the shortest time possible. They should discuss their treatment with their doctor if they have any doubt. “
digital NHS figures show that there were 14,605,791 prescription items dispensed in England in 2015 by NSAIDs.
The BMJ research was conducted by a team from the University of Milano-Bicocca in Italy.
Courtesy: The Independent