Painkillers commonly prescribed for arthritis are more dangerous than previously believed, especially for heart patients
by: S. Johnson
NSAIDs (Nonsteroidal Anti-Inflammatory Drugs) are frequently used to treat pain, fever, inflammation, headaches and arthritis. NSAIDs are not antibiotics, meaning that they are not a sufficient treatment option for bacterial infections. Millions of Americans rely on NSAIDs to ease pain and reduce inflammation. They’ve been associated with an increased risk of ulcers and heightened blood pressure.
The heart of the problem
In the recent study, published in the prestigious European Heart Journal, the researchers found that arthritis medicine is particularly dangerous for heart patients, and that older types of arthritis medications, which had not been extensively reviewed, also seem dangerous to the heart.
Project leader Morten Schmidt, MD and PhD from Aarhus University, said in a press release:
“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.
“This is worrying, because these older types of medicine are frequently used throughout the western world and in many countries available without prescription.”
Formulating new guidelines for doctors
The study was conducted in collaboration between 14 European universities and hospitals, as well as a number of heart specialists. Over the course of the study, the researchers collected all data on the use of NSAIDs in patients with heart disease. The survey will help the European Society of Cardiology devise a set of recommendations for what doctors should review prior to prescribing painkillers for heart 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,” said professor Christian Torp-Pedersen from Aalborg University, who was involved in the study.
“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,” he added.
An estimated 15 percent of people in western countries are prescribed NSAIDs. This figure increases with age. Approximately 60 percent of adults in Denmark act on at least one prescription for an NSAID within a decade. Previous research suggested that nearly 40 percent of Danish patients with heart failure or past heart attacks are prescribed NSAIDs.
Danish researchers have been a force in this particular line of research, and their work has helped reduce the use of Diclofenac in Denmark. Nevertheless, according to Morten Schmidt, more work needs to be done:
“Many European countries consume more of these drugs than Denmark. But we can still do better and it’s often the case that paracetamol, physiotherapy, mild opioids or other types of NSAIDs with less risk for the heart would be better for the patients. Of course, the recommendations that have been introduced following our study and its review of the heart-related risks are a big step in the right direction in relation to patient safety.”
Back in 2015, the U.S. FDA issued a public health alert about NSAIDs and their relationship with heart problems:
“The U.S. Food and Drug Administration (FDA) is strengthening an existing label warning that non-aspirin nonsteroidal anti-inflammatory drugs (NSAIDs) increase the chance of a heart attack or stroke.”