Got a headache? Take Advil. Menstrual cramps? Pop some Advil. Shoulder injury acting up? It’s Advil to the rescue. Or is it?
Research published in the March issue of European Heart Journal: Cardiovascular Pharmacotherapy is a warning to anyone who takes non-steroidal anti-inflammatory drugs (NSAIDs)—such as ibuprofen—on a regular basis. The study found that these drugs may increase the risk of a heart attack by up to 30 percent.
Using the Danish Cardiac Arrest Registry, the researchers collected data on all patients who had an out-of-hospital cardiac arrest in Denmark between 2001 and 2010 and data on all redeemed prescriptions for NSAIDs from Danish pharmacies since 1995. Using each patient as both case and control over two distinct time periods, their use of NSAIDs during the 30 days before cardiac arrest was compared to their use of NSAIDs during a preceding 30-day period without cardiac arrest. Use of any NSAID (both non-selective NSAIDs such as diclofenac, naproxen, ibuprofen, and COX-2 selective inhibitors such as rofecoxib and celecoxib) was associated with a 31 percent increased risk of cardiac arrest.
How exactly could these drugs increase the risk of a heart attack? NSAIDs affect the cardiovascular system in several ways: They can influence platelet aggregation, cause blood clots, cause the arteries to constrict, increase fluid retention, and raise blood pressure.
“Diclofenac and ibuprofen, both commonly used drugs, were associated with significantly increased risk of cardiac arrest. NSAIDs should be used with caution and for a valid indication,” warned Dr. Gislason. “They should probably be avoided in patients with cardiovascular disease or many cardiovascular risk factors.” (Find out other ways you can prevent heart disease.)
According to Dr. Gislason, a major issue is just how readily available NSAIDs are, which sends the public the wrong message (i.e. these drugs must be safe for me if they are being sold in a convenience store). “I don’t think these drugs should be sold in supermarkets or gas stations where there is no professional advice on how to use them,” he said. “Over-the-counter NSAIDs should be available only at pharmacies, in limited quantities, and in low doses.”
As well as consulting a health-care professional before taking NSAIDs, Dr. Gislason offered further advice on taking NSAIDs: “Do not take more than 1,200 mg of ibuprofen per day. Naproxen is probably the safest NSAID, and we can safely take up to 500 mg a day. Diclofenac is the riskiest NSAID and should be avoided by patients with cardiovascular disease and the general population. Safer drugs are available that have similar painkilling effects, so there is no reason to use diclofenac.”