May 22, 2006 — Common painkillers raise the risk of heart
failure-related hospitalization in people over 60, a new study
shows.
The risk is even greater for those who already have heart failure. And even
very short-term painkiller use can be dangerous, the study finds — especially
for people taking blood-pressure-lowering medications.
The drugs are known as nonsteroidal anti-inflammatory drugs or NSAIDs. Those
implicated in the study are:

Indocin tripled the risk of heart failure-related hospitalization.
Naproxen (brand names include Aleve and Naprosyn) doubled the risk of heart
failure-related hospitalization.
Ibuprofen (brand names include Advil and Motrin) increased the risk of
heart failure-related hospitalization by 43%.

Overall Risk Small
The study, by Consuelo Huerta, MD, MPH, of the Spanish Center for
Pharmacoepidemiologic Research in Madrid, Spain, looked at data on 228,660
patients collected in the U.K. from 1997 through 2000.
While the NSAID drugs increased patient’s risk, the overall risk was small
for most. However, the drugs are considerably more dangerous for those who
already have heart failure.
“Use of NSAIDs was associated with a small risk of a first
hospitalization for heart failure,” Huerta and colleagues report. “In
patients with a prior clinical diagnosis of heart failure, the use of NSAIDs
may lead to worsening of pre-existing heart failure that triggers their
hospital admission.”
The study appears in the current early online edition of the journal
Heart.
NSAIDs and Blood Pressure
The new findings don’t surprise heart experts, says Andrew L. Smith, medical
director for the heart failure and transplant
programs at Emory University in Atlanta.
“The data from this study is not surprising to those of us who manage a
lot of patients with heart failure,” Smith tells WebMD. “NSAIDs can
contribute to high blood
pressure. This is not commonly recognized among primary care
providers. It is a difficult situation, because a lot of heart patients have
arthritis and other
problems for which these medicines provide relief.”
With all the attention given the heart risks of Vioxx, it’s easy to forget
that over-the-counter painkillers also have risks, says Carl Lavie, MD, medical
co-director of cardiac rehabilitation and preventive cardiology, Ochsner Clinic
Foundation in New Orleans.
“Doctors don’t think anything of giving patients these NSAIDs that raise
blood pressure, inhibit the aspirin they need for heart disease
prevention, and increase the risk of heat attacks and strokes,” Lavie tells
WebMD. “And now this paper, like others before it, shows higher heart
failure risk. Doctors have to recognize that all these drugs have risks — not
just the ones advertised by the lawyers.”
Blood Pressure Drugs
For people taking blood pressure drugs — diuretics (water pills), ACE
inhibitors, or beta-blockers — there’s an even greater risk. Even short-term
use of NSAIDs boosts heart failure-related hospitalizations in these patients,
the Huerta study shows.

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