Use of NSAIDs by Healthy Users Raises Risk of Heart Attack

Danish Study Says NSAIDs Use Raises Risk of Heart Attack in Healthy Users
By Susie Madrak Saturday Jun 12, 2010

Healthy people who take nonsteroidal anti-inflammatory drugs to relieve minor aches and pains may raise their risk of dying from heart-related problems, a Danish study finds.

The American Heart Association and the U.S. Food and Drug Administration already warn people with heart disease to be cautious about taking NSAIDs, which include ibuprofen (brand named Advil, Motrin) and diclofenac.

The new study is the first to show the same kind of increased risk among people without cardiac problems, says a report in the July issue of Circulation: Cardiovascular Quality and Outcomes, published online June 8.

"Very few studies have been designed to answer the important question: Do NSAIDs also increase the cardiovascular risk among healthy people who use these drugs for minor complaints?" said lead author Dr. Emil L. Fosbol, a cardiologist at Gentofte University Hospital in Hellerup. "This study is the first to confirm that the cardiovascular risk is indeed increased when healthy individuals use some of the drugs."

The risks for different NSAIDs — found in an analysis of national medical records of more than 1 million Danes from 1997 to 2005 — varied widely. Participants, whose average age was 39, who used ibuprofen had a 29% greater risk of fatal or nonfatal stroke, compared to those who took no NSAID.

Use of diclofenac (Voltaren and Cataflam) was associated with a 91% higher risk of death from all cardiovascular diseases, while rofecoxib (Vioxx) use was associated with a 66% increased risk. But the study found no increased risk of cardiovascular problems — indeed, a slightly lower risk of death — associated with naproxen, sold over the counter with brand names including Aleve.

For people taking the largest doses, diclofenac was associated with a doubled risk of heart attack, and rofecoxib (Vioxx) was associated with a threefold increased risk of heart attack. Vioxx was taken off the U.S. market in 2004 because of a study finding high rates of heart attack and stroke.