Commonly Used Pain Relievers Linked to Heart Disease Risk

Some of the most commonly used pain relievers are associated with an increased risk of heart failure, new research shows.

Specifically, current use — meaning use in the preceding 14 days — of any NSAID was found to be associated with a 19 percent increased risk of hospital admission for heart failure, according to a study that was recently published in the British medical publication BMJ.

“NSAID” is short for “non-steroidal anti-inflammatory drugs,” a class of drugs used to treat pain and inflammation.

Use of a new generation of anti-inflammatory drugs known as selective COX-2 inhibitors was also found to be associated with an increased risk of hospital admission for heart disease.

The study was based on data on almost 10 million NSAID users from four European countries and data on 27 NSAIDs, including 23 traditional NSAIDs and four COX-2 inhibitors.

The researchers, led by Giovanni Corrao at the University of Milano-Bicocca in Italy, found that the degree of risk for hospital admission for heart disease varied depending on the drug and dose.

For example, the risk was higher for seven NSAIDs and two COX-2 inhibitors:

• Diclofenac (NSAID)
• Ibuprofen (NSAID)
• Indomethacin (NSAID)
• Ketorolac (NSAID)
• Naproxen (NSAID)
• Nimesulide (NSAID)
• Piroxicam (NSAID)
• Etoricoxib (COX-2 inhibitor)
• Rofecoxib (COX-2 inhibitor)

For five of those drugs, when taken at very high doses, the risk of hospital admission for heart failure doubled:

• Diclofenac
• Etoricoxib
• Indomethacin
• Piroxicam
• Rofecoxib

Because the study was observational, it does not prove a cause-and-effect relationship between use of NSAIDs or COX-2 inhibitors and hospitalization for heart failure.

The researchers note, however, that their study adds to existing evidence of an association between these drugs and an increased risk of hospitalization for heart failure. Additionally, in an editorial about this study, two Danish heart experts note:

“Owing to the widespread use of NSAIDs, even a small increase in cardiovascular risk is a concern for public health.”

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