Do pain medications carry different heart risks?

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Prior studies have suggested that non-steroidal anti-inflammatory drugs (NSAIDs) may be linked with higher cardiovascular risks, but few have assessed potential different cardiovascular risk between NSAID classes or across individual NSAIDs.

A British Journal of Clinical Pharmacology study including 55,629 with hypertension in a Taiwanese database did not observe different cardiovascular risks in patients who received cyclooxygenase-2 enzyme selective NSAIDs or nonselective NSAIDs during 4 weeks of follow-up.

The study also found no apparent difference in cardiovascular risk when comparing celecoxib with diclofenac, ibuprofen, or naproxen, although a significantly increased risk was observed when comparing celeocxib with mefenamic acid.

"Our results provide important information about the comparative safety of alternative NSAID use in patients with hypertension in real-world settings. Under low-to-moderate daily dose and a short-term treatment period, most commonly used NSAIDs have similar cardiovascular safety profiles," said co-author Dr. Chia-Hsuin Chang, of the National Taiwan University Hospital.

More information: Xiaogang Liu et al, Ticagrelor attenuates myocardial ischemia-reperfusion injury possibly through downregulating galectin-3 expression in the infarct area of rats, British Journal of Clinical Pharmacology (2018). DOI: 10.1111/bcp.13536

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