Widely used painkillers such as ibuprofen and naproxen can increase the risk of a heart attack, especially within the first month of use in high doses, a new study suggests.
An international team of researchers led by Michele Bally, who now works for the Montreal Hospital Research Centre, reviewed multiple health-care databases on heart attack risks associated with non-steroidal anti-inflammatory drugs, or NSAIDs.
The patient data came from Canada, the United Kingdom and Finland. Researchers analyzed the results of 446,763 people, of whom 61,460 had already had a heart attack. The study, published in The BMJ, focused on the use of ibuprofen, celecoxib, diclofenac, naproxen, and rofecoxib.
The researchers concluded that taking any dose of NSAIDs for one week, one month or more than a month was associated with an increased risk of a heart attack.
They also found that the risk was greatest when the drugs were taken in higher doses during the first month of use. The increased risk was noted as early as within the first week of NSAID use.
Because this was an observational study, researchers note that a cause-and-effect relationship between painkillers and heart attacks could not be conclusively established. Still, they say that their study was the largest investigation of its kind and should serve as a caution to physicians and health care practitioners who prescribe NSAIDs.
Bally, the lead author of the study, told CTV News Channel on Wednesday that the study is “very important from a public health standpoint” because millions of people around the world take painkillers on a regular or semi-regular basis.
Bally said the study should not scare people away from reaching for an over-the-counter painkiller to help with pain and inflammation. But people should take the opportunity to talk to their doctor and pharmacist about their individual heart attack risks and what types of painkillers they should be using, she said.
“People have to know that their own personal risk, in general, is not high,” she said.
Dr. Michael Farkouh, a cardiologist with the Peter Munk Cardiac Centre in Toronto, said that ibuprofen, for example, can affect blood pressure and the function of blood vessels. Ibuprofen is sold in Canada under brand names Advil and Motrin.
But any risks associated with NSAIDs are dose-dependent, Farkouh told CTV News Channel.
“I think the take-home message here is to take the drug with the least frequency and with the lowest doses,” he said.
Previous studies have also suggested that NSAIDs could increase the risk of heart damage.
