PEOPLE WHO USE common painkillers could be raising their risk of having a heart attack, according to a study in the BMJ.
The study, which looked at prescribed non-steroidal anti-inflammatory drugs (or NSAIDs, the technical term for what are common painkillers) found that there was an increased risk as early as in the first week of use and especially within the first month of taking high doses of such medication.
NSAIDs analysed included celecoxib, the three main traditional NSAIDs (diclofenac, ibuprofen, and naproxen), and rofecoxib. They’re used to treat everything from headaches to sprains to arthritis symptoms.
The type of analysis the researchers used allowed them to conclude with greater than 90% probability that all NSAIDs studied are associated with a heightened risk of heart attack.
Previous studies suggested that NSAIDs could increase the risk of a heart attack, but the timing of the risk, the effect of dose, treatment duration, and the comparative risks between NSAIDs weren’t covered as comprehensively as this new study.
Results
The study found that taking any dose of NSAIDs for one week, one month, or more than a month was associated with an increased risk of heart attack.
Overall, the increase in risk of a heart attack is about 20-50% if using NSAIDs compared with not using these medications.
To put this in perspective, as a result of this increase, the risk of heart attack due to NSAIDs is on average about 1% annually.
Further analysis suggested that the risk of heart attack associated with NSAID use was greatest with higher doses and during the first month of use.
With longer treatment duration, risk did not seem to continue to increase but the researchers caution that they did not study repeat heart attacks such that it remains prudent to use NSAIDs for as short time as possible.
About the study
A team of researchers, led by Michèle Bally of the University of Montreal Hospital Research Center, carried out a systematic review and a meta-analysis (an overview rather than a detailed look) of relevant studies from various healthcare databases including those from Canada, Finland and the UK.
They analysed results on 446,763 people – of whom 61,460 had a heart attack.
To provide guidance, the researchers presented their results as probabilities of having a heart attack. They looked at various scenarios corresponding to how people might routinely use these drugs.
This is an observational study based on drug prescribing or dispensing and not all potentially influential factors could be taken into account.
Although this means that conclusions cannot be made about cause and effect, the authors say that their study was the largest investigation of its type and that its real-world origin helped to ensure that findings were broadly generalisable.
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