Painkillers linked to increased risk of heart failure

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Common painkillers used by millions of people are linked to an increased risk of heart failure, experts have said.

Non-selective non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen could increase the risk of being admitted to hospital with the heart problem, a study found.

Previous studies have linked the drugs to abnormal heart rhythm, which can cause heart failure, and an increased risk of heart attack and stroke if taken regularly.

The drugs, together with a sub-group of anti-inflammatories known as selective COX-2 inhibitors, are used to control pain and inflammation and are commonly taken by people with arthritis.

The new study, published in the British Medical Journal (BMJ), used data for almost 10m NSAIDs users from the UK, Netherlands, Italy, and Germany, who started NSAID treatment between 2000 and 2010.

Overall, 92,163 hospital admissions for heart failure were identified among the group.

The study found people who had taken any NSAID in the previous 14 days had a 19% increased risk of hospital admission for heart failure compared with people who had used NSAIDs at any point in the past.

The risk of admission for heart failure increased for seven traditional NSAIDs (diclofenac, ibuprofen, indomethacin, ketorolac, naproxen, nimesulide, and piroxicam) and two COX 2 inhibitors (etoricoxib and rofecoxib).

The increased risk of hospital admission ranged from 16% for naproxen to 83% for ketorolac.

Researchers also found that the risk of heart failure doubled for diclofenac, etoricoxib, indomethacin, piroxicam, and rofecoxib used at very high doses, although they stressed this should be interpreted with caution.

Even medium doses of indomethacin and etoricoxib were associated with increased risk, the study said, but there was no evidence that celecoxib increased the risk of admission for heart failure at commonly-used doses.

The experts said the study “offers further evidence that the most frequently used individual traditional NSAIDs and selective COX 2 inhibitors are associated with an increased risk of hospital admission for heart failure.

Moreover, the risk seems to vary between drugs and according to the dose.”

In an accompanying editorial, two Danish health researchers said that owing to the widespread use of NSAIDs, “even a small increase in cardiovascular risk is a concern for public health”.

They said the fact they can be bought over the counter in supermarkets “further fuels the common misconception that NSAIDs are harmless drugs that are safe for everyone”.

Professor Peter Weissberg, medical director at the British Heart Foundation, said: “This large observational study reinforces previous research showing that some NSAIDs, a group of drugs commonly taken by patients with joint problems, increase the risk of developing heart failure.

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