Better Health: Smart Health Commentary Better Health (TM): smart health commentary

Article Comments

NSAIDs Might Be Risky For People With Heart Problems

As if people with the combination of high blood pressure and heart disease don’t already have enough to worry about, a new study suggests that common painkillers called nonsteroidal anti-inflammatory drugs (NSAIDs) pose special problems for them.

Among participants of an international trial called INVEST, those who often used NSAIDs such as ibuprofen (Advil, Motrin and others), naproxen (Aleve, Naprosyn, and others), or celecoxib (Celebrex) were 47% more likely to have had a heart attack or stroke or to have died for any reason over three years of follow-up than those who used the drugs less, or not at all. The results were published in the July issue of the American Journal of Medicine.

Millions of people take NSAIDs to relieve pain and inflammation. They are generally safe and effective. The main worry with NSAIDs has always been upset stomach or gastrointestinal bleeding. During the last few years, researchers have raised concerns that their use may be hard on the heart as well.

This one study, and the handful that have come before it, don’t mean that people with high blood pressure and heart disease or other cardiovascular conditions should stop taking NSAIDs, especially if they are used to ease pain from a chronic condition like arthritis. But it may make sense to try an alternative first.

Talk with your doctor about taking aspirin instead of ibuprofen, naproxen, or other traditional NSAID. Aspirin eases pain and inflammation and also offers protection against myocardial infarction (heart attack) and the most common kind of stroke.

Try acetaminophen (Tylenol and many generic versions) instead of an NSAID. Be careful not to take more than 3,250 milligrams in a 24-hour period, and read medication labels—many combination over-the-counter products contain acetaminophen.

If aspirin or acetaminophen doesn’t give you enough relief, try a low-dose NSAID. Early studies suggested that naproxen it may be safer than ibuprofen, although this has been challenged.

If you take ibuprofen and aspirin, take the aspirin at least 30 minutes before the ibuprofen or eight hours afterward. Aspirin’s ability to protect the heart depends on its fitting snugly into the pocket of an enzyme known as cyclooxygenase. Ibuprofen can block aspirin’s entry into this pocket.

____________________________________
*Dr. LeWine’s biography can be viewed <a href=”http://www.harvardhealthcontent.com/AskTheExpert/72,ATD071311″>here</a>.

*This blog post was originally published at Harvard Health Blog*


You may also like these posts

Read comments »


Comments are closed.

Return to article »

Latest Interviews

IDEA Labs: Medical Students Take The Lead In Healthcare Innovation

It’s no secret that doctors are disappointed with the way that the U.S. healthcare system is evolving. Most feel helpless about improving their work conditions or solving technical problems in patient care. Fortunately one young medical student was undeterred by the mountain of disappointment carried by his senior clinician mentors…

Read more »

How To Be A Successful Patient: Young Doctors Offer Some Advice

I am proud to be a part of the American Resident Project an initiative that promotes the writing of medical students residents and new physicians as they explore ideas for transforming American health care delivery. I recently had the opportunity to interview three of the writing fellows about how to…

Read more »

See all interviews »

Latest Cartoon

See all cartoons »

Latest Book Reviews

Book Review: Is Empathy Learned By Faking It Till It’s Real?

I m often asked to do book reviews on my blog and I rarely agree to them. This is because it takes me a long time to read a book and then if I don t enjoy it I figure the author would rather me remain silent than publish my…

Read more »

The Spirit Of The Place: Samuel Shem’s New Book May Depress You

When I was in medical school I read Samuel Shem s House Of God as a right of passage. At the time I found it to be a cynical yet eerily accurate portrayal of the underbelly of academic medicine. I gained comfort from its gallows humor and it made me…

Read more »

Eat To Save Your Life: Another Half-True Diet Book

I am hesitant to review diet books because they are so often a tangled mess of fact and fiction. Teasing out their truth from falsehood is about as exhausting as delousing a long-haired elementary school student. However after being approached by the authors’ PR agency with the promise of a…

Read more »

See all book reviews »