Common painkillers are more dangerous than we think

Many Danes are prescribed NSAIDs for the treatment of painful conditions, fever and inflammation. But the treatment also comes with side effects, including the risk of ulcers and increased blood pressure. A major new study now gathers all research in the area. This shows that arthritis medicine is particularly dangerous for heart patients, and also that older types of arthritis medicine, which have not previously been in focus, also appear to be dangerous for the heart.

‘It’s been well-known for a number of years that newer types of NSAIDs – what are known as COX-2 inhibitors, increase the risk of heart attacks. For this reason, a number of these newer types of NSAIDs have been taken off the market again. We can now see that some of the older NSAID types, particularly Diclofenac, are also associated with an increased risk of heart attack and apparently to the same extent as several of the types that were taken off the market,’ says Morten Schmidt, MD and PhD from Aarhus University, who is in charge of the research project. He adds:

‘This is worrying, because these older types of medicine are frequently used throughout the western world and in many countries available without prescription.’

Each year, more than 15 per cent of the western countries collects a prescription for NSAIDs. This figure increases with age. Sixty per cent of the adult population in Denmark collects at least one prescription for an NSAID within a ten-year period. Heart patients are no exception and previous studies have shown that up to forty per cent of Danish patients with heart failure or previous heart attacks are prescribed NSAIDs.

The study, which was carried out in collaboration between 14 European universities and hospitals, including a number of leading European heart specialists, is today being published in the most prestigious European journal of heart medicine, European Heart Journal.

In the study, the researchers have gathered all research on the use of NSAIDs in patients with heart disease. The survey means that the European Society of Cardiology has now for the first time formulated a number of recommendations about what doctors should consider before prescribing painkillers to their patients.

‘When doctors issue prescriptions for NSAIDs, they must in each individual case carry out a thorough assessment of the risk of heart complications and bleeding. NSAIDs should only be sold over the counter when it comes with an adequate warning about the associated cardiovascular risks. In general, NSAIDs are not be used in patients who have or are at high-risk of cardiovascular diseases,’ says another of the authors, Professor in cardiology Christian Torp-Pedersen, Aalborg University, Denmark. EurekAlert