Ibruprofen and other commonly used painkillers for treating inflammation may increase the risk of heart attack, researchers from The University of Nottingham say in this week’s BMJ.
Patients should not stop taking the drugs involved - non-steroidal anti-inflammatory drugs (NSAIDS) - but further investigation into these treatments is needed, say the authors.
In the biggest study of its kind to date, researchers identified 9,218 patients aged between 25 and 100 across England, Scotland and Wales who suffered a heart attack for the first time over a four-year period. The data came from the QRESEARCH database, run by the University in collaboration with the IT software provider EMIS. QRESEARCH automatically collects real-time anonymised clinical data from 500 GP practices (representing around 3.5 million patients) throughout the UK.
The researchers, led by Professor Julia Hippisley-Cox in the University’s Division of Primary Care, looked at the prescribing patterns for these patients, tracking whether and when they had been prescribed NSAIDS. NSAIDS are commonly prescribed to relieve inflammation and pain, and include ibruprofen, diclofenac, naxproxen, celecoxib and rofecoxib, as well as a host of other less-commonly prescribed anti-inflammatories.
The findings were adjusted to allow for several other heart attack risk factors - including age, obesity and smoking habits. Importantly, they also adjusted for whether the patient had already suffered from heart disease, or whether they were being prescribed aspirin.
The researchers found that for those prescribed NSAIDS in the three months before the heart attack, the risk increased compared with those who had not taken these drugs in the previous three years. For ibruprofen, the risk increased by almost a quarter (24 per cent) and for diclofenac it rose by more than half (55 per cent).
The newer generation of anti-inflammatories - COX-2 inhibitors - were also associated with increased rates of first-time heart attack. Those prescribed the drugs in the proceeding three months were at 21 per cent higher risk of heart attack if taking celecoxib, and 32 per cent increased risk if taking rofecoxib.