Danish researchers created a major overview of Nonsteroidal Anti-Inflammatory Drugs (NSAIDs), which are commonly used for treating painful conditions, fevers and inflammation. The research revealed that these common painkillers are more dangerous than previously believed, particularly for the heart.
NSAIDs are sold over the counter in small doses in aspirins for minor aches and are prescribed in stronger doses for more serious diseases of the muscular and bone systems, such as arthritis.
The new study, which was a collaboration among 14 European universities and hospitals, including several leading European heart specialists, collected all research that has been done in this area, indicating that arthritis painkillers are particularly hazardous for heart patients, and that older forms of arthritis medication, which have not previously been focused on, also appear to be dangerous for the heart.
"It's been well-known for a number of years that newer types of NSAIDs - what are known as COX-2 inhibitors - increase the risk of heart attacks," said lead researcher Morten Schmidt from Aarhus University. "For this reason, a number of these newer types of NSAIDs have been taken off the market again. We can now see that some of the older NSAID types, particularly Diclofenac, are also associated with an increased risk of heart attack and apparently to the same extent as several of the types that were taken off the market."
"This is worrying, because these older types of medicine are frequently used throughout the Western world and in many countries, available without prescription," he added.
The research team gathered all research on NSAIDs use in patients with heart disease. As a result, for the first time, the European Society of Cardiology now has a series of recommendations about what doctors should take into consideration before giving prescriptions for painkillers to patients.
"When doctors issue prescriptions for NSAIDs, they must in each individual case carry out a thorough assessment of the risk of heart complications and bleeding," explained study co-author Christian Torp-Pedersen from Aalborg University.
"NSAIDs should only be sold over the counter when it comes with an adequate warning about the associated cardiovascular risks. In general, NSAIDs are not be used in patients who have or are at high-risk of cardiovascular diseases," he said.
Each year, more than 15 percent of the populations of Western countries is given a NSAIDs prescription, a figure that increases with age. While the Centers for Disease Control and Prevention (CDC) have recently warned doctors in the U.S. about prescribing highly addictive narcotic painkillers, the risks associated with common NSAIDs often remain to be addressed.
"We can still do better," Schmidt said, "and it's often the case that paracetamol, physiotherapy, mild opioids or other types of NSAIDs with less risk for the heart would be better for the patients."
The findings were published on March 16 in the European Heart Journal.
