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The High Price of Pain Relief

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ibuprofen

New study links ibuprofen and other NSAIDs with a greater risk of heart attacks.

Danish researchers have linked some of the most common over-the-counter pain-relief drugs to an increased risk of heart attacks, and they advise consumers — especially those with a history of heart problems — to limit or avoid them.

The new study, published in the European Heart Journal — Cardiovascular Pharmacotherapy, focused on nonsteroidal anti-inflammatory drugs (NSAIDs) available by prescription in Denmark, but these included two of America’s most popular nonprescription painkillers, ibuprofen and naproxen (sold under the brand names Advil and Aleve, respectively). People who took ibuprofen were 31 percent more likely to suffer a heart attack than those who avoided the drug. Naproxen, which is rarely prescribed in Denmark, was not associated with a higher risk of cardiac arrest.

Diclofenac, a common prescription painkiller sold under various brand names, including Cambia, was associated with a 50 percent higher risk of heart attack.

The Danish research is only the latest in a series of studies in recent years suggesting a link between NSAIDs and heart troubles. Scientist believe the painkillers affect blood clotting, constrict the arteries, increase fluid retention, and raise blood pressure.

“The findings are a stark reminder that NSAIDs are not harmless,” lead study author Gunnar Gislason of the University of Copenhagen said in a statement. “Diclofenac and ibuprofen, both commonly used drugs, were associated with significantly increased risk of cardiac arrest.”

He cautions consumers to limit their daily use of ibuprofen to 1,200 milligrams and take no more than 500 milligrams of naproxen. And he’d like to see them sold only in limited quantities of low doses in pharmacy settings. “The current message being sent to the public about NSAIDs is wrong. If you can buy these drugs in a convenience store, then you probably think: ‘They must be safe for me,’” he said. “Our study adds to the evidence about the adverse cardiovascular effects of NSAIDs and confirms that they should be taken seriously and used only after consulting a healthcare professional.”

Christopher O’Connor, MD, editor-in-chief of the American College of Cardiology journal JACC: Heart Failure, argues that Gislason’s recommendations to limit access to ibuprofen and other over-the-counter pain meds would harm people who face little risk from the drugs. “I don’t want my 20-year-old son who twists his ankle playing soccer to walk around in pain because he’s scared to take ibuprofen,” O’Connor told TIME.

“I would say the message here is to be careful taking nonsteroidals, particularly high doses, and particularly if you have preexisting cardiovascular disease,” he added.

In addition to increasing heart-attack risk, NSAID overuse has also been linked to joint deterioration, bleeding ulcers, renal problems, and autoimmune disease.

The Mayo Clinic advises NSAID users to take the lowest possible dose for the shortest period of time. But there are a variety of nondrug approaches to fighting chronic pain. For an overview of these options, see “This Is Your Body on Ibuprofen” in our June 2014 issue.

 

is an Experience Life deputy editor.

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