HEALTH COACH - NSAID-related pain relievers associated with an increased risk of heart attack

HEALTH COACH -

NSAID-related pain relievers associated with an increased risk of heart attack The probability of having a heart attack was calculated to increase on average by 20% to 50%, compared to a person who Not the drugs, regardless of dosage and amount of time that medications are taken.
The results are observational and based on an association, however, the drugs did not prove to be a direct cause of a heart attack.
This group of drugs includes ibuprofen, diclofenac, celecoxib and naproxen, which are available over the counter or by prescription for higher doses to relieve pain or fever, 39 a range of causes, including flu, headaches, back pain and menstrual cramps. Their range of uses also means that they are often taken as needed, for short periods of time.
The level of risk increased within a week in the use of any drug in this category and at any dose, and the risk associated with taking higher doses was greatest during Of the first month.
"We have found that all common NSAIDs have shared an increased risk of heart attack," said Michèle Bally, epidemiologist at the University's Research Center for Hospitals Of Montreal, who led the research. "There is a perception that naproxen has the lowest cardiovascular risk (among NSAIDs), but this is not true."
The global discovery of the researchers was that taking any dose of these drugs for a week, a month or more was linked to an increased risk of a heart attack. The risk seemed to be decreasing when these painkillers were no longer taken, with a slight decrease from one to 30 days after use and a sharper decrease falling below 11% between 30 days and one year after l & # 39; use.
Based on The newspaper, published Tuesday in the BMJ, the Bally team suggests that doctors and patients weigh on potential risks and benefits before relying on drugs as Processing option.
"People minimize the risks because medicines are over-the-counter and they do not read labels," Bally said. "Why not consider all treatment options? ... Each therapeutic decision is a balance of benefits and risks. "

Based on previous research

Cardiovascular diseases are the no. Deaths, according to the World Health Organization, with 80% of all deaths in this category due to heart attacks and strokes. Each year, an estimated 735 000 people
Previous research has shown that this class of analgesics may increase the risk of heart attacks in the United States. Risk of a heart attack, known as myocardial infarction.In 2015, the US Food and Drug Administration asked drug manufacturers to update their labels of warnings To identify u N increased risk of heart attack or stroke.

Bally and her team have reviewed all available studies in this area from Canadian and European databases, analyzing the results of 446,763 people, with 61,460 of them having a heart attack.Their objective was to calculate the risk, determinants and time of heart attacks associated with heart attack, The use of NSAIDs in typical circumstances.
The team examined the use at very short term and at any dose, Bally said. "In real life , People use drugs at low doses and use them at the same time "She said, adding that this is not reflected in many clinical trials, for example, in which people have often been monitored during prolonged use of these drugs.
When used for one week, the highest risk was associated with rofecoxib, followed by diclofenac, ibuprofen and celecoxib, respectively, although all except celecoxib Had similar levels of risk, oscillating around 50% increased likelihood of a heart attack, at any dose.

At higher doses, usually requiring a prescription, some drugs had an even higher risk of heart attack between one week and one month of use. For example, naproxen showed an increased probability of 75% of a heart attack in a month with doses of 1200 milligrams per day or more, and naproxen showed an increased probability of 83% Heart attack with doses greater than 750 milligrams per day when taking a week to a month.
But the level of risk decreased, on average, when the drugs were used for more than one month.
"This is relative to not taking these drugs, your baseline Risk," Bally said. "Risk is not 75%. "
Millions of these pills are sold every year, Bally said." Therefore, the risk, no matter Size or parent, is important to note from the point of view of the population. "

" We already know That these drugs increase your risk of having a heart attack, "said Dr. Mike Knapton, medical director associated with the British Heart Foundation, in a statement. "However, this large-scale study focuses on the speed with which you may have a heart attack after starting NSAIDs." Knapton did not participate in the research.
Knapton added that people need to be informed of the risk and that alternative medications or treatments should be taken into account, if any. For example, physical therapy or yoga could be used to relieve the pain of an injury.

Association, not causality

The researchers emphasize that the results are purely observational, they have used readily available data on certain populations. All potentially influential factors could not be taken into account, they say.
[19459109]

Stephen Evans, Professor of Pharmacoepidemiology At The London School of Hygiene & Tropical Medicine, said that a number of lifestyle factors, such as smoking and body mass index, are not available in the data on participants in l & # 39; study. "This leads to uncertainty," he said.

Tobacco use, unhealthy diet, obesity, alcohol abuse and high blood pressure are just a few of the factors that Can cause a heart attack.

"This is the largest study of its kind, but it is always observation data based on information on prescribing or distribution, rather than on whether People actually take their medications, "said Dr. Amitava Banerjee, senior lecturer in clinical research at UCL in the UK." Although these data reflect the actual use of NSAIDs, it is impossible to control All factors that can lead to confusion or bias. "

This uncertainty combined with the general nature of the observed results means the increased risk cause shown in the analysis can not

Bally believes that a cause could be changes in blood pressure or effects on the heart. Renal function because these areas are poorly studied. But she points out that the five drugs studied have individual behaviors. "It will be difficult to point out a factor," she said.

Relative risk, not absolute

"The document has good evidence that there is a risk of a heart attack for all NSAIDs and suggests that Risk ratio immediately begins to start, but is expressed only in relative terms, "said Evans, who did not participate in the research. "There is no clear description of the absolute risk."

The results are based on the chances of a heart attack occurring in people taking these drugs, compared to those who do not take them. If the risk was already low in a person, an increased risk of 20% to 50% is not very worrying.

"The risks are relatively low and for most people who do not run a high risk A heart attack, these results have minimal implications," said Evans.

It is also It is possible that people taking these medications are already on average at a higher risk than those who do not take medicines, he said, commenting that the study did not take these Factors in their calculations.For example, the reason why somebody is prescribed an NSAID, as for severe pain, maybe also the reason why they have a heart attack soon after. The study shows that the risk of a heart attack increases shortly after taking NSAID, the links may not be as clear as suggested, said Evans.

"Mechanisms Most likely for ac Medication should be low risk early and would only have an effect on heart attacks after longer use.

"All effective medicines have undesirable effects, but they do not, And NSAIDs, although readily available, do not involve certain risks, but this study is not a reason to induce anxiety Most users of these drugs, "he said

But while awaiting greater clarity on the true level of risk and its cause, experts always recommend caution when prescribing or taking these painkillers.

Increased risk of heart attack with NSAIDs, regardless of it, means that health professionals and the public should weigh the harm and benefit when prescribing these drugs, especially for more than 39 , A day or two, "said Banerjee.

" Despite the availability Ity of traditional NSAIDs, this precaution is always required. The mechanism of this increased risk of heart attack is not at all clear from existing studies. "

HEALTH INFO

Search This Blog