|Posted on July 5, 2017 at 1:15 AM|
NSAIDS…Heart Attack & Stroke
In the last couple of years we have heard many concerns surrounding NSAID (non-steroidal inflammatory drugs). Recently, a group of medical professionals sought to distinguish fact from fiction surrounding claims of NSAID use dangers. The quest was to determine what dosage and duration was linked to elevated risk for myocardial infarction (MI) —heart attack— and stroke. Was someone taking an NSAID for a headache a higher risk? Did that risk increase or stay the same is the drug was taken daily for a period of time? Importantly, did the dosage of the drug have an impact on risk factors?
A review of 82 studies that included 446,763 patients aged 40 to 79 years old. Of those patients, 61,460 had an MI. Increased risk for heart attack was associated with the use of all NSAIDs (ibuprofen, naproxen, and rofecoxib*) used in the studies and began immediately after exposure — often within 1 to 7 days.
The researchers found the higher the dosage of NSAIDs, regardless of which one used, was associated with high risk for MI. A 50% increase in risk was noted over 8 to 30 days following use among patients taking higher doses of NSAIDS. High dose was defined as follows 1200 mg daily of ibuprofen, 750 mg daily of naproxen, and greater than 25 mg daily of rofecoxib*. This increased risk for heart attack did not continue to increase under longer durations. Please note these same risks occurred for patients without any history of heart disease.
Currently, ibuprofen (Advil/Motrin) and naproxen (Aleve) are considered the main go to over-the-counter pain relievers for musculoskeletal injury and inflammation. Unfortunately, many people are unknowingly placing themselves at risk for more serious problems when dosing at higher amounts. Under these circumstances it may be a better choice to pursue physical therapy, acupuncture, yoga, and other natural avenues to address chronic pain. Carefully weigh your pain against the risk of MI before reaching for the bottle.
*rofecoxib is generic for Vioxx that was removed from the marketplace several years ago. It had been prescribed for some of the patients included in this research review. Thus it is included in these findings.
Dianna Richardson, ND July 2017
Bally, Michèle, et al. “Risk of Acute Myocardial Infarction with NSAIDs in Real World Use: Bayesian Meta-Analysis of Individual Patient Data.” BMJ. 2017;357: j1909. doi: 10.1136/bmj.j1909
Non-Aspirin Non-Steroidal Anti-Inflammatory Drugs (NSAIDs): Drug Safety Communication — FDA Strengthens Warning of Increased Chance of Heart Attack or Stroke. US Food & Drug Administration. Updated July 09, 2015. Available at: https://www.fda.gov/Safety/MedWatch/SafetyInformation/SafetyAlertsforHumanMedicalProducts/