Routinely taking common anti-inflammatory painkillers could put people at a heightened risk of heart attack, Canadian research has found.
Experts have drawn a link between taking non-steroidal anti-inflammatory drugs (NSAIDs), which are used to treat pain and inflammation, and an increased risk of heart attacks.
Doctors should consider the “risks and benefits” before dishing out the commonly prescribed drugs, particularly at higher doses, the authors cautioned.
The study published in journal The BMJ adds to growing evidence that suggests NSAIDs, including ibuprofen and naproxen, are potentially dangerous in some patients with cardiac risk factors, says Professor John McNeil, head of the Monash University School of Public Health & Preventive Medicine.
However, he says, these drugs can provide substantial relief to many patients.
“The longstanding advice to take the lowest effective dose for the shortest time is sound, especially in those whose risk of heart disease is already high. There was no substantial difference in risk between any of the commonly used NSAIDS,” Prof McNeil said.
Researchers from Canada, Finland and Germany conducted an analysis of previous studies, which held data on almost 450,000 people – 61,460 of whom had suffered a heart attack.
They found that taking any dose of NSAIDs for one week, one month, or more than a month was associated with an increased risk of myocardial infarction (heart attack), according to the study.
They said there was a “a rapid onset of risk” for heart attack within the first week of use, while risk was highest during the first month of taking the painkillers.
Using the drugs for longer than one month did not increase risk more than with shorter use, the researchers found.
Risk was higher among users on high doses of the painkillers.
Use for between eight and 30 days at a high dose was “particularly harmful” when people were taking more than 1200mg a day of ibuprofen, 750mg a day of naproxen and more than 25mg a day of rofecoxib, they wrote.
Overall, the increased risk of suffering a heart attack was between 24 per cent and 58 per cent if taking celecoxib, ibuprofen, diclofenac, naproxen and rofecoxib, compared with not using these medications.
“Compared with non-use of NSAIDs in the preceding year, we documented that current use of all studied NSAIDs, including naproxen, was associated with an increased risk of acute myocardial infarction,” the authors wrote.
Although they did stress that conclusions should not be drawn about cause and effect.
“Given that the onset of risk of acute myocardial infarction occurred in the first week and appeared greatest in the first month of treatment with higher doses, prescribers should consider weighing the risks and benefits of NSAIDs before instituting treatment, particularly for higher doses.”