Nov. 28, 2005 - Long-term use of two popular over-the-counter pain relievers
does not appear to increase a person’s risk of having a heart attack, a study
from the U.K. shows.
Researchers reported no increase in risk among people who took either
ibuprofen or naproxen for a year or longer in moderate doses.
Ibuprofen and naproxen are among the best-selling nonsteroidal
anti-inflammatory drugs (NSAIDs). Ibuprofen-based pain relievers include Advil,
Motrin, and Nuprin. Naproxen-based products include Aleve and Naprosyn.
A slight, but significant, increase in risk for nonfatal heart attacks was
seen among people who took the prescription NSAID diclofenac, known by the
brand name Voltaren, for more than a year. Voltaren is one of the most popular
pain relievers in Europe, but it is not as widely prescribed in the U.S.
The findings suggest that when it comes to cardiovascular risk, not all
NSAIDs are created equal, the study’s researcher tells WebMD.
“It appears that there is a small increase in risk for certain NSAIDs
under certain circumstances,” says Luis A Garcia Rodriguez, MD. “But it
is definitely not what we would call a major effect.”
It has been just over a year since the popular prescription pain reliever
Vioxx was pulled from the market amid concerns about an increase in heart
attack and stroke risk among users. The pain reliever Bextra, which is
chemically similar to Vioxx, was withdrawn from the market for the same reason
in April of this year.
Measuring NSAID Risk
Concerns have been raised about the long-term safety of more traditional
anti-inflammatory pain relievers. In an effort to better understand the risks,
Garcia Rodriguez and colleague Antonio Gonzalez-Perez of the Spanish Center for
Pharmacoepidemiological Research assessed the short- and long-term use of
NSAIDs as a class and also looked specifically at three of the most commonly
used NSAIDs.
Their findings are published in the Nov. 28 issue of the journal BMC
Medicine.
Close to 5,000 heart attack patients and 20,000 people who had not had heart
attacks were included in the study.
No increase in heart attack risk was seen among people who took moderate
doses of ibuprofen, naproxen, or diclofenac for less than a year.
Although the overall longer use (over a year) of all traditional NSAIDs was
associated with a 20% increase in the risk for nonfatal heart attacks, the
longer use of ibuprofen specifically appeared to have no impact on risk.
Use of diclofenac demonstrated a small increased risk for heart attack with
longer use.
Use of naproxen for longer than a year was associated with a slight decrease
in heart attack risk, but it was not clear if the association was real.
“Our study suggests either no effect or a small reduction of
cardiovascular risk during sustained treatment with naproxen, a small increased
risk with diclofenac, and an undetectable risk with ibuprofen,” Garcia
Rodriguez and Gonzalez-Perez wrote.

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