risk of a heart
attack
.
Taking painkillers for just
one week 'raises the risk of a heart attack': Strongest doses of five types of
drug can increase chance by up to half
.
· Data
from nearly 450,000 patients has linked 5 painkillers to heart problems
· Five
forms are ibuprofen, celecoxib, diclofenac, naproxen, and rofecoxib
· People
who take strong doses are most at risk, Canadian researchers found
By Ben Spencer Medical Correspondent For The Daily Mall
Taking ibuprofen or other common painkillers for only a week increases
the risk of a heart attack, research suggests.
Data from
nearly 450,000 patients has linked five forms of painkillers – ibuprofen,
celecoxib, diclofenac, naproxen, and rofecoxib – to heart problems.
People
who take strong doses of the drugs – called non-steroidal anti-inflammatory
drugs (NSAIDs) – are the most at risk, the Canadian researchers found.
In
relative terms, the risk of a heart attack rose by between a fifth and a half
compared to not taking any painkillers, the team calculated.
The
researchers from the University of Montreal stressed that because most people
have only a small risk of a heart attack to start with, the absolute risk of an
attack directly contributed to taking NSAIDs is only about 1 per cent a year.
But they
said doctors should consider alternative painkillers.
Writing in the British Medical Journal, the
researchers said: 'Given that the onset
of risk of acute [heart attack] occurred in the first week and appeared
greatest in the first month of treatment with higher doses, prescribers should
consider weighing the risks and benefits of NSAIDs before instituting
treatment, particularly for higher doses.'
They said for ibuprofen in particular, taking a
high dose was especially risky. 'Use for
eight to 30 days at a high dose was particularly harmful for ibuprofen (more
than 1200 mg/day),' they wrote.
This is
well within the maximum recommended dose for adults, which is 400mg three or
four times a daily – a total of up to 1,600mg.
They
found patients who took ibuprofen for a week had a 48 per cent increased
relative risk of a heart attack, those who took celecoxib saw a 24 per cent
increase, diclofenac 50 per cent, naproxen 53 per cent and refecoxib 58 per
cent.
For those
who continued taking ibuprofen for up to a month, the increase in risk went up
to 75 per cent.
Researchers
suspect the drugs may cause arteries to constrict, increase fluid retention and
raise blood pressure.
Alternative
theories include the possibility that they encourage the clumping of platelets
and formation of blood clots.
The researchers carried out a 'meta-analysis' of all previous studies on the subject, combining the results to make a study of 446,763 people, of whom 61,460 had suffered a heart attack.
The researchers carried out a 'meta-analysis' of all previous studies on the subject, combining the results to make a study of 446,763 people, of whom 61,460 had suffered a heart attack.
The authors said it
was the largest investigation into the topic ever conducted.
Dr Mike Knapton, associate medical director at the
British Heart Foundation, said: 'This
large-scale study worryingly highlights just how quickly you become at risk of
having a heart attack after starting NSAIDs.
'Whether you are being prescribed painkillers like
ibuprofen, or buying them over the counter, people must be made aware of the
risk and alternative medication should be considered where appropriate.'
Professor Kevin McConway, of the Open University,
added: 'This new study has helped
persuade me that there is probably a real association between taking these
painkillers and heart attacks.
'But, despite the large numbers of patients
involved, some aspects do still remain pretty unclear.
'It remains possible that the painkillers aren't
actually the cause of the extra heart attacks. We've got to remember that all
drugs have side effects, and that people aren't prescribed these painkillers
for fun, but to deal with a real pain problem.'
John Smith, chief executive of the Proprietary
Association of Great Britain, the UK trade association representing
manufacturers of over-the-counter medicines, said: 'People taking over-the-counter NSAIDs should not be concerned by this
research if they are taking the medicine occasionally for short periods and
according to the on-pack instructions.
'The study also showed that after patients had
taken their last prescribed dose of an NSAID, their risk of having a heart
attack then decreased over time back to normal levels of risk.'
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