Some nonsteroidal anti-inflammatory drugs ( NSAIDs ) are associated with significantly higher risks of dying from heart-related causes among healthy people, according to new research reported in Circulation: Cardiovascular Quality and Outcomes, a journal of the American Heart Association.

The study is the first to report on specific cardiovascular risks among healthy people.

Over nine years, researchers at Gentofte University Hospital in Hellerup, Denmark, compared medical outcomes of otherwise healthy Danish residents taking prescription NSAIDs with those who had not taken NSAIDs.

Compared to those who did not take a prescription NSAID, the study found that:
• Ibuprofen use was associated with a 29 percent greater risk of fatal or non-fatal stroke;

• Diclofenac was associated with a 91 percent greater risk of cardiovascular death;

• Rofecoxib was associated with a 66 percent increased risk of cardiovascular death.

For people taking the highest-level doses, Diclofenac and Rofecoxib were associated with a two and three times higher risk of having a myocardial infarction, respectively. Both drugs had dose-dependent increases in cardiovascular risks in the study.

In contrast, Naproxen wasn’t associated with any increases in heart-related problems.

In the epidemiological study, researchers used Danish national medical records for 1,028,437 healthy people over age 10, collected from 1997 through 2005. The median age was 39. At least 44.7 percent of the study population took NSAIDs at least once during this time. Most in the study used an NSAID for about two weeks, and usually in low doses.

People in the study were assumed to be healthy if they had not been in contact with the Danish nationalized hospital system for the five years before their first NSAID prescription and if they had no prescriptions for serious medical problems two years before the study.

The researchers focused on Ibuprofen ( Brufen ), Diclofenac ( Voltaren ), Rofecoxib ( Vioxx ), Celecoxib ( Celebrex ) and Naproxen ( Naprosyn ). Researchers were unable to establish conclusive results about the heart risks of Celecoxib.
Results of the study emphasize the need for the general population to be aware of cardiovascular risks with commonly used NSAIDs.

The study findings are consistent with a 2007 American Heart Association scientific statement that advised doctors about evidence that the use of NSAIDs [ except Acetylsalicylic Acid ( Aspirin ) ] for chronic pain increased the risks for myocardial infarction and stroke. For those patients with or at high risk for cardiovascular disease, it recommended a stepped-care approach to pain management, based on a patient’s risk profile, in which doctors use higher heart risk medications only after lower-risk treatments prove inadequate.

Source. American Heart Association, 2010

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