Weighing heart risks with pain relief not easy
www.news-press.com
March 4, 2008
The American Heart Association now recommends stopping ALL non-steroidal anti-inflammatory drugs (NSAIDs) except aspirin in heart attack patients. Such popular NSAIDs include Motrin, Advil, Aleve, Naprosyn, and their generics, ibuprofen and naproxen.
For a few years now, there have been signs that regular use of these medications could be a problem. In 2004 Vioxx was voluntarily withdrawn from the market after a study showed a 200 percent increase in heart-related events such as heart attacks. This was the first indication that all NSAIDs may have unwanted side effects.
But hold your horses! These new recommendations from the American Heart Association are geared towards patients with a history of heart attack or unstable heart disease. Specifically, the evidence used to make these recommendations was based on data that showed patients who had taken a NSAID within a week before having a heart attack seemed to have had a higher risk of death or a recurrent heart attack.
Meanwhile, for many, managing pain is still a major medical issue, and avoiding all NSAIDs may be much easier said than done.
There should be a stepwise approach in heart patients. Start with Tylenol (acetaminophen), then aspirin or other aspirin-like drugs, and if needed try a NSAID such as naproxen, which seems to be the least risky in regard to heart attacks. When an NSAID such as ibuprofen or naproxen is needed in patients with heart disease, it should be used at the lowest dose and for the shortest time period possible.
Also, remember that for most of us without significant risk factors for heart disease, using these NSAIDs for the occasional muscle pain and headaches of daily life is fine.
Surely many people reading this will have questions, and it is important that we remember all patients are different. Weighing the risk of heart disease with the relief of pain will not be a simple equation for all. So discuss your concerns with your family doctor or cardiologist. |
