Anti-inflammatory medications ibuprofen, diclofenac may up heart issues

Two painkillers often used as anti-inflammatory medication may increase the risk of heart problems.

People who take high doses of ibuprofen and diclofenac -- both of which are non-steroidal anti-inflammatory drugs (NSAIDs) -- for an extended period of time were shown to be at a greater risk for heart problems. NSADs are often taken to combat inflammation, including rheumatoid arthritis.

Researchers looked at almost 650 randomized trials and discovered that taking either 2,400 milligrams of ibuprofen daily or 150 milligrams of diclofenac had a one-third increased chance of getting a heart attack, stroke or early death. More than 353,000 patients were included in the study review.

Specifically, for every 1,000 patients with a moderate risk for heart disease, three would have a heart attack if they took high doses of NSAIDs for a year. One of those three would be fatal.

"Three per thousand per year sounds like it is quite a low risk, but the judgment has to be made by patients," lead researcher Colin Baigent, professor of epidemiology and honorary consultant in public health at The University of Oxford in Oxford, England, explained to the BBC. "So if you're a patient and you go and sit in front of your doctor and discuss it, you are the one who should be making the judgment about whether three per thousand per year is worth it to allow you, potentially, to go about your daily life."

Subjects also had a two to four times greater risk for bleeding ulcers or other significant upper gastrointestinal problems.

"The higher your risk of heart disease, the higher your risk of a complication. Roughly speaking, if you've got double the risk of heart disease, then the risk of having a heart attack is roughly double," he added.

Dr. Suzanne Steinbaum, a preventive cardiologist at Lenox Hill Hospital in New York City, explained to HealthDay that because NSAIDs are often necessary to help patients manage their condition, the study can help doctors decide which of the treatments and how much of the medication provides the best benefits for patients, especially those who are at high risk for heart disease.

"Considering NSAIDs are some of the most commonly used medications and their increased risk of heart disease, stroke, heart failure and death is significant, this meta-analysis may help doctors in guiding patients [about] which NSAID -- and at what dose -- might be the safest for them," Steinbaum, who did not participate in the study, pointed out.

Donald Singer, a professor of clinical pharmacology and therapeutics at Britain's Warwick University, who was not involved in the study, told Reuters that the study showed that powerful treatments may have harmful side effects.

"It is therefore important for prescribers to take into account these risks and ensure patients are fully informed about the medicines they are taking," he said.

The study was published on May 29 in The Lancet.

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