Ibuprofen May Increase Heart Attack Risk
Ibuprofen is a popular and widely-used drug, which is the most familiar type among the class of drugs known as nonsteroidal anti-inflammatory drugs (NSAIIDs). NSAIIDs are commonly used to alleviate pain and have historically been considered relatively safe in comparison to most drugs used for pain relief (even though some research has indicated the curcumin may be even more effective than ibuprofen for pain relief).
However, recent research out of the University of Montreal, which was published in the British Medical Journal, suggests that the use of NSAIIDs may increase the risk of suffering a myocardial infarction, commonly known as a heart attack.
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How the Research was Conducted
Rather than conducting an original patient-based study, the researchers performed an observational study to draw their conclusions. In performing their evaluation, the researchers analyzed the results compiled from 446,763 people in healthcare databases across several countries, among whom 61,460 people had experienced a heart attack. They focused on five common types of NSAIIDs, which in addition to ibuprofen, included:
Researchers focused on five common types of NSAIIDs, which in addition to ibuprofen, included:
- Naproxen (Aleve, Naprosyn, Ec-Naprosyn, Midol, Mediproxen, All Day Pain Relief, Flanax, Wal-Proxen, Comfort Pac-Naproxen, All Day Relief, others)
- Diclofenac (Voltaren, Cambia, Solaraze, Zipsor, Pennsaid, Flector, Dyloject, DermacinRx Lexitral, Sure Result DSS Premium Pack, Xenaflamm, others)
- Celecoxib (Celebrex)
- Rofecoxib (Vioxx)
In making their conclusions, they considered patient outcomes for those who had taken NSAIIDs versus those who had not, and focused their attention on the timeframe within the first month of regular use.
What did the Researchers Find?
The highlight finding of the research was that all five types of NSAIIDs were associated with an increased risk of heart attack, with the researchers citing a greater than 90% probability for this association. To add specificity, the risk of experiencing a heart attack was 20-50% greater among patients who used the drugs versus those who did not, with the precise increase in risk depending upon the specific type of NSAIID medication.
Part of the strength of the identified association was the fact that “the onset of risk of [a heart attack] occurred in the first week and appeared greatest in the first month of treatment with higher doses”, according to the authors. Nevertheless, the researchers conceded that there was still much to learn regarding the dosage, timing, and duration of NSAIID usage, not to mention a shortcoming in our understanding about the variations between the outcomes of different types of medications within this class.
Although the findings of the study do indicate a significantly increased risk of experiencing a heart attack in accordance with taking NSAIIDs, there are qualifying factors that need to be considered. For one, as the researchers used an observational approach to their study, causality cannot be proved, meaning that they are unable to explicitly state that the use of NSAIIDs caused the heart attacks, as confounding factors could exist. Additionally, critics of the research pointed out that the risk of suffering a heart attack were relatively small from the outset, meaning the implications would have little relevance to most people.
What to Consider when Using NSAIIDs
Deciding whether or not to use NSAIIDs depends on many factors and should be determined based on the context of each unique situation and individual. Most importantly, people who are at a heightened risk for a heart attack should exercise more caution and strongly consider alternative options, while those who are at a relatively low risk are unlikely to be affected. Limiting the duration and degree of use of NSAIIDs is a great way to limit the risks of a heart attack as well as any other unwanted side effects.
Moreover, as evidenced by the ongoing opioid epidemic in the United States, the risks of taking other types of pain medications may be substantially greater, potentially leaving NSAIIDs as a preferable choice in some cases even when an elevated risk exists.
Alternatively, there are options for pain relief outside the realm of medication, including a variety of new techniques. New types of medications are worth consideration too, such as CBD oil, not to mention ancient techniques for pain relief. There are also specific types of pain that might be targeted in unique manners, as evidenced by the example of using arnica as relief for joint and muscle pain. Lastly, being mindful of our pain levels and our ability to manage them is a powerful tool.
If we’re able to think conscientiously about what we are experiencing, perhaps there will be times when we can tolerate some pain without turning to medication. Regardless of the situation, employing a mindful approach will support our ability to make better decisions when it comes to taking—or not taking—medication for pain relief.