COMMENTARY

NSAIDs -- Which Ones Hurt the Heart? Which Don't?

Sandra A. Fryhofer, MD

Disclosures

November 24, 2010

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No one really thinks much about popping a nonsteroidal anti-inflammatory drug (NSAID) for minor complaints, but we should. A 9-year study finds that certain pain relievers can increase cardiovascular risk, even in healthy people.[1]

The study was based on detailed registry data of more than 1 million NSAID users. The average age was 39 years.

Researchers looked at several different types of NSAIDs. Here are the results:

  • Ibuprofen -- 29% greater risk for fatal or nonfatal stroke;

  • Rofecoxib -- 66% increased risk for cardiovascular death. (Remember the high rate of heart attack and stoke is why it was taken off the US market back in 2004.);

  • Diclofenac -- 91% increased risk for cardiovascular death. (Diclofenac has high COX-2 inhibition selectivity.);

  • Celecoxib -- findings inconclusive. The number of events was too small but available data did seem to show a trend for increased cardiovascular risk; and

  • Naproxen -- NOT associated with any increased cardiac risk.

That why these researchers say naproxen is the safest choice for your heart.

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