Research finds association between certain pain relievers and heart attack

July 10, 2014 by Morgan Sherburne
Myocardial Infarction or Heart Attack. Credit: Blausen Medical Communications/Wikipedia/CC-A 3.0

(Medical Xpress)—For women taking certain kinds of pain relievers, a heart attack could be waiting in their medicine cabinets.

A University of Florida study has found that the regular use of some non-steroidal anti-inflammatory drugs, or NSAIDs, increases the risk of stroke, heart attack and death in postmenopausal women. The study was published this week in the journal Circulation: Cardiovascular Quality and Outcomes.

The researchers found that regular use of the NSAID naproxen, the active ingredient in medications such as Aleve, is associated with a 10 percent increased risk of heart attack, stroke and death in postmenopausal women, said UF cardiologist Dr. Anthony Bavry, the study's lead author. Regular use was defined as at least twice per week for the previous two weeks.

"That is counter to the medical community's perception of NSAIDs, in which most people believe naproxen to be safer," Bavry said. "Our study showed naproxen was not safer—it was actually harmful."

Bavry, in collaboration with researchers from Harvard and other universities, combed through data from more than 160,000 who were surveyed as part of the Women's Health Initiative—a 15-year research study funded by the National Institutes of Health. Of these women, 53,142 regularly used NSAIDs. Even after controlling for obesity, hypertension, diabetes, use of aspirin and other health factors, the researchers found the increased risk for heart attack, stroke or death among the women who used certain types of NSAIDs.

One of the study's co-authors, Dr. Marian Limacher, has been the UF principal investigator for the Women's Health Initiative since 1994. She emphasized that the study was observational in nature, which helped the researchers find associations between use of NSAIDs and cardiovascular impacts. Limacher also noted that this was the first study of its size to examine the effects of regular NSAID use on women.

"When we study agents such as aspirin, we have found differential effects in men and women," Limacher said. "Men had reduction in heart attack, and older women had a reduction in stroke but not heart attack, which is part of the reason those of us studying women feel we really need to have adequate information on commonly used drugs for both men and women,"

NSAIDs include over-the-counter medications such as naproxen and ibuprofen as well as prescription drugs such as rofecoxib, commercially branded as Vioxx, and celecoxib, branded as Celebrex. Because of its association with increased risk of heart attack or stroke, Vioxx was taken off the market in 2004.

The study's main finding confirmed that the regular use of any NSAID was associated with harm such as digestive bleeding. Although it found for the first time that the risk of heart attack, stroke or death was associated with the use of naproxen, the study found no cardiovascular or stroke harm associated with ibuprofen.

NSAIDs work by inhibiting two enzymes responsible for inflammation, called cox-1 and cox-2. They also can cause bleeding in the stomach and . NSAIDs that target just the cox-2 enzyme, which is present mainly at the site of inflammation, are designed to prevent bleeding in the digestive tract, Bavry said.

However, previous studies showed that NSAIDs that solely target the cox-2 enzyme, which include Vioxx and Celebrex, have been associated with adverse cardiovascular events such as or . Bavry thinks the culprit in naproxen is also cox-2 inhibition.

"People will have to think about what they have in their own medicine cabinet," Bavry said. "Do they have naproxen, ibuprofen or something else?"

The study looked only at the association between cardiovascular events and use of NSAIDs—not the effects of NSAIDs on the kidneys, for example.

"We would encourage patients to use medications for as short a time as they need, and to be sure they follow up with their physicians regularly to monitor for effects on the kidneys, and potentially for risk for heart disease," Limacher said.

Explore further: FDA advisers revisit heart risks posed by painkillers (Update)

Related Stories

FDA advisers revisit heart risks posed by painkillers (Update)

February 10, 2014
(HealthDay)—Naproxen—the key pain reliever in Aleve—seems safer for the heart than other popular anti-inflammatory drugs such as ibuprofen (Advil and Motrin), U.S. health officials say.

Guidelines for safe use of NSAIDs in older people ignored

July 1, 2014
Research by the University of Sydney has found that older Australians are taking non-steroidal anti-inflammatory drugs (NSAIDs) for too long and without sufficient precautions to minimise harmful side-effects.

Daily aspirin may guard against ovarian cancer

February 6, 2014
(HealthDay)—Taking aspirin every day might lower a woman's risk of developing ovarian cancer by one-fifth, a new study suggests.

Short term use of painkillers could be dangerous to heart patients

May 9, 2011
Even short-term use of some painkillers could be dangerous for people who've had a heart attack, according to research published in Circulation: Journal of the American Heart Association.

Taking painkillers increases death risk, second heart attacks in survivors

September 10, 2012
Heart attack survivors who take common painkillers after a heart attack have a higher long-term risk of dying or having a second heart attack, according to a new study published in Circulation, an American Heart Association ...

NSAIDs do not increase risk of miscarriages, study reports

February 3, 2014
Women who take nonsteroidal anti-inflammatory drugs (NSAIDs) during pregnancy are not at increased risk of miscarriages, confirms a new study published in CMAJ (Canadian Medical Association Journal).

Recommended for you

Could aggressive blood pressure treatments lead to kidney damage?

July 18, 2017
Aggressive combination treatments for high blood pressure that are intended to protect the kidneys may actually be damaging the organs, new research from the University of Virginia School of Medicine suggests.

Quantifying effectiveness of treatment for irregular heartbeat

July 17, 2017
In a small proof-of-concept study, researchers at Johns Hopkins report a complex mathematical method to measure electrical communications within the heart can successfully predict the effectiveness of catheter ablation, the ...

Concerns over side effects of statins stopping stroke survivors taking medication

July 17, 2017
Negative media coverage of the side effects associated with taking statins, and patients' own experiences of taking the drugs, are among the reasons cited by stroke survivors and their carers for stopping taking potentially ...

Study discovers anticoagulant drugs are being prescribed against safety advice

July 17, 2017
A study by researchers at the University of Birmingham has shown that GPs are prescribing anticoagulants to patients with an irregular heartbeat against official safety advice.

Protein may protect against heart attack

July 14, 2017
DDK3 could be used as a new therapy to stop the build-up of fatty material inside the arteries

Heart study finds faulty link between biomarkers and clinical outcomes

July 14, 2017
Surrogate endpoints (biomarkers), which are routinely used in clinical research to test new drugs, should not be trusted as the ultimate measure to approve new health interventions in cardiovascular medicine, according to ...

1 comment

Adjust slider to filter visible comments by rank

Display comments: newest first

kmackin99
1 / 5 (1) Jul 13, 2014
My aunt had terrible arthritis. When she discovered Vioxx, she got her life back. She could laugh and enjoy life again. Then, they took it away and my aunt died bitter and sad. The insane decision to remove the only pain reliever that worked for my aunt destroyed the last years of her life. Would it not be better to warn people and let them make health decisions for themselves?

Better five joyous years than ten miserable ones... Why are adults being treated like children?

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.