When it comes to relieving pain, your primary care doctors and specialists at The Medical Group of South Florida can rely on a host of medications to do the job. Our aim is always to begin with the lowest dose of the safest drug available, and increase the dosage or change the prescription until the aim of pain relief is achieved.
The most widely prescribed pain relievers are the non-steroidal anti-inflammatory drugs (NSAIDs). These drugs, however, have not proven to be risk-free. In recent years, NSAIDs have been implicated in such side effects as ulcers, bleeding or holes in the stomach and intestine, and liver damage for some people.
Now, a new study published in the British Medical Journal (BMJ) raises further concerns about this class of drug. It found an association between those taking even over-the-counter (OTC) doses of certain NSAIDs and an average 20% to 50% increase in the likelihood of experiencing a heart attack within a week of starting the drug.
The drugs examined in the study include the OTC drugs ibuprofen (Advil) and naproxen (Aleve, Midol, and Naprelan), as well as the prescription drugs diclofenac (Solaraze, Cambia, and Voltaren) and celecoxib (Celebrex), and implicated all of them in the increased risk.
“We found that all common NSAIDs shared a heightened risk of heart attack,” Dr. Michele Bally, an epidemiologist at the University of Montreal Hospital Research Center, who led the research team, told CNN. “There is a perception that naproxen has the lowest cardiovascular risk (among the NSAIDs), but that’s not true.”
It’s important to note that the study’s findings were based on association, and did not necessarily prove a causal link between consumption of the drugs and heart attacks. The study was observational, meaning the researchers examined available data about certain populations, and clinical trials were not conducted. Thus, typical contributory factors to heart disease and heart attacks such as obesity, smoking, and poor lifestyle choices were not controlled for during the study.
Nevertheless, this study reinforces earlier research that linked NSAIDs to heightened cardiovascular risk. For this study, Bally performed a meta-analysis of research from health care databases in the United Kingdom, Canada, and Finland, analyzing information previously gathered on 446,763 people, of whom 61,460 had suffered a heart attack.
The large sample size of the study tends to lend weight to its findings, which revealed that—contrary to earlier beliefs—the risk kicks in as soon as with one week of use.
On the other hand, Bally cautioned users not to panic, adding that the absolute risk of a heart attack after consuming these drugs is very small.
“These numbers do not mean that a person has a 20 to 50 percent risk of having a heart attack after taking those drugs,” she told CBS News.
Rather, the findings mean that as a result of this increase, the risk of heart attack due to NSAIDs is on average about 1 percent annually, she said.
“I think this study is another cautionary tale to be very careful before using these drugs and not be lulled into a place of complacency just because they’re over the counter,” Deepak Bhatt, M.D., executive director of interventional cardiovascular program at Brigham and Women’s Hospital, told CBS News. “If someone has to use an NSAID for pain relief, the best advice is to use the lowest possible dose and for shortest amount of time possible.”
As your primary care physicians and specialists at The Medical Group of South Florida have noted before, all drugs—including OTC drugs—carry some form of risk. Therefore, we always take these effects into consideration before prescribing any medication for our patients, carefully tailoring treatment plans to individual need and detailed health history. We urge you to discuss your concerns and questions with us whenever you begin taking any form of medication.