May 22 2006
New research has revealed that commonly used over-the-counter painkillers, such as ibuprofen, are linked with a 30% increased risk of first hospital admission for heart failure.
The researchers say that though that risk may at first glance appear quite small, it has implications in particular for the elderly who are at greater risk of heart failure.
They say the revelation may also have a considerable impact on public health.
The researchers from the Spanish Centre for Pharmacoepidemiological Studies in Madrid, examined data from the General Practice Research Database, which contains the anonymised medical records of millions of patients registered with family doctors across the UK.
For the research they identified all patients who were aged between 60 and 84 on January 1 1997 and monitored them up to the end of December 2000.
They found that factors such as having a previous diagnosis of heart failure, obesity, being a smoker, and having a history of recent specialist appointments and inpatient stays were all associated with a greater chance of being admitted to hospital for heart failure for the first time.
They also found that fourteen per cent of patients were taking non-steroidal anti-inflammatory drugs (NSAIDs) at the time of their admission compared with 10% of the comparison group of randomly selected people.
Half of those admitted to hospital were men, and half were aged between 70 and 79.
It appeared that of all the NSAIDs, people taking indomethacin seemed to be at the highest risk and were over three times as likely to be admitted to hospital for heart failure as those not taking the drug.
Osteoarthritis was the most common reason for taking NSAIDs.
The authors say the figures suggest that there would be one extra first hospital admission for heart failure for every 1000 people aged between 60 and 84 taking NSAIDs, which is small but also suggest that this could rise to three additional cases among patients aged 70 and older with conditions, such as diabetes, high blood pressure, or kidney failure.
As heart failure is a common cause of illness and death among the elderly, the researchers say even a small increase in the risk can translate into a significant disease burden in the general population.
Patients with arthritis are commonly prescribed NSAIDs such ibuprofen, naproxen, diclofenac, indomethacin and meloxicam.
The modern alternatives to NSAIDs are COX-2 inhibitors such as Vioxx which has already been withdrawn for increasing the risk of heart attack and stroke in a trial.
Many patients with osteoarthritis use NSAIDs to make life bearable, so the extra risk of heart failure is unlikely to change their habits.
The study emphasises the need for powerful painkillers with fewer side-effects.
As heart failure is a common cause of illness and death among the elderly, the researchers say even a small increase in the risk can translate into a significant disease burden in the general population.
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