High doses of painkillers used by millions can increase the risk of heart attacks, strokes and heart failure, according to the largest study of its kind.
It confirmed a ‘small but significant’ extra risk of dying from heart problems after prolonged use. The drugs, known as non-steriodal anti-inflammatory drugs (NSAIDs), include ibuprofen and diclofenac, and also newer medication called coxibs. They are used by people with arthritis and other forms of chronic pain.
For every 1,000 people with a moderate risk of heart disease taking them for one year, three extra people would have an avoidable heart attack including one death. This is more than one-third above the normal risk if not taking the drugs. The study found naproxen was the safest NSAID.
Researchers looked at the highest doses of painkillers prescribed by doctors, twice the daily amount recommended for headache and other minor ailments. They said a short course of tablets bought over the counter for a muscle sprain was unlikely to be hazardous.
The study pooled the finds from 639 trials involving over 353,000 people after numerous small trials showed a link between NSAIDs and heart side-effects. Study leader Professor Colin Baigent, of the Medical Research Council Clinical) Trial service Unit & Epidemiological Studies Unit at Oxford University, said the results would help patients to balance the benefits and risks of using the drugs, and that they should not panic.
He said: ‘We’re talking about really low risks. The extra risk of a heart attack is very small. But if patients are worried they could talk to their doctors about it and they can consider if the risks, which are real but small, are worth it for them.’
At least several million people with arthritis take painkillers, including NSAIDs such as ibuprofen, diclofenac and coxibs. The research found for every 1,000 people with a moderate risk of heart disease having one year of treatment with high-dose diclofenac (150mg daily) or ibuprofen (2400mg daily), about three would experience an avoidable heart attack, of which one would be fatal.
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