NSAIDs are turning out to be more dangerous than anyone ever imagined
Casual use, serious dangers
Extended use of non-steroidal anti-inflammatory drugs (NSAIDs) increases risk of gastrointestinal bleeding.
That danger is pretty widely known. Probably not widely ENOUGH, but it’s common knowledge.
What’s less well known is that long-term use of prescription NSAIDs prompts well over 100,000 hospitalizations every year due to upper gastrointestinal adverse events.
That’s horrible, but here’s what’s tragic: More than 16,500 of those patients die–every year! And those statistics don’t even include another grave side effect linked to prescription NSAIDs: cardiovascular events.
One study found that NSAID use after age 60 may increase heart failure risk by 30 percent. And that risk rises sharply in the presence of other heart problems such as high blood pressure or type 2 diabetes.
And now, unfortunately, we have to add a new item to that grim list of potential adverse effects: stroke.
Massive public-health implications
Researchers in Denmark realized they had an ideal opportunity to track NSAID risks.
Two reasons: 1) In Denmark, each citizen’s health records are kept in national registries. And 2) You need a prescription to get common NSAIDs in Denmark, and a record of those prescriptions goes into the registries.
It’s a little unsettling that the registries seem to be an open book, but that’s another issue.
Researchers at Gentofte University began by combing through the registries looking for healthy individuals who had not been prescribed any medications for chronic conditions within two years, and had not been admitted to a hospital within five years.
This gave the GU team health and prescription records for about half a million people to work with. Of that half million, about 45 percent had been prescribed an NSAID.
Nearly HALF–that’s a pretty astonishing finding by itself!
Researchers followed prescription records for two “COX-2 selective” NSAIDs: Celebrex and Vioxx (the study began before the Vioxx fiasco unfolded). Also followed: three “non-selective” NSAIDs: naproxen (Aleve), diclofenac (Cataflam), and ibuprofen (Advil, Motrin).
When prescription data was analyzed alongside hospitalization and death registry data, ibuprofen was linked with a 30 percent increased risk of stroke.
Think about that. Ibuprofen, used for a limited time by healthy people appears to significantly increase stroke risk. Speaking at a cardiology conference, the lead researcher noted the potential for “massive public-health implications.”
Of course, he’s also trying to sell the importance of his study. But a Duke University cardiologist with no ties to the research said this was the first time well-documented NSAID use was linked to cardiovascular disease events.
He added: “It shows that people should not take these drugs casually but think about whether [the drugs] are really needed.”
With you all the way, Doc!
Other results in the study showed that diclofenac may sharply increase stroke risk (more than 85 percent!), but that Aleve did not appear to increase stroke risk much at all.
In all five medications, higher doses produced increased stroke risk.
Of course, none of this is proof–large placebo-controlled trials will be needed for that. But until then, like the doctor says, do not take these drugs casually.
Sources:
“Visible Small-Intestinal Mucosal Injury in Chronic NSAID Users” Clinical Gastroenterology and Hepatology, Vol. 3, No. 1, January 2005, cghjournal.org
“NSAID Use Linked to Boosted Stroke Risk in General Danish Population” Mitchel L. Zoler, Elsevier Global Medical News, medconnect.com.au
“NSAID Use Associated With Future Stroke in Healthy Population” Sue Hughes, Medscape Medical News, 9/8/10, medscape.com
