UK study finds that painkillers may cause heart attacks

Commonly used painkillers have come under an extensive scrutiny by British scientists, who say that more research is needed into the safety of painkillers as they have found evidence that some painkillers could increase the risk of heart attacks in patients who routinely use them.

These comments were made after it was found that Ibuprofen, an anti-inflammatory that is commonly prescribed by doctors increases the risk of having a cardiac arrest within three months by almost 24 percent. For other painkillers such as diclofenac, the risk of an arrest rose to about 50 percent. These findings are a part of the study, which observed 9,218 patients who had suffered their first heart attack. These patients were aged between 25 and 100 and were spread across England, Scotland and Wales.

The study revealed that patients, who were prescribed non-steroidal anti-inflammatory drugs, or NSAIDs, in the three months before the heart attack occured, were found to be at a greater risk than those who had never taken these drugs in the past three years. The study has been published in the latest issue of the British Medical Journal.

Professor Julia Hippisley-Cox of the University of Nottingham in England, said, " We think more data and more research is needed to formally evaluate the safety of all these drugs. Our findings support existing knowledge and raise questions over additional drugs." She added that the findings of the study could have "considerable implications for public health."

In April, the Food and Drug Administration (FDA) in the United States had found that the painkillers, more specifically the COX-2 inhibitors, caused a variety of adverse effects and had called for stronger warnings on the same. This study had found that Rofecoxib, a COX-2 inhibitor had the highest level of risk. This drug was subsequently withdrawn.

Professor Peter Weissberg of the British Heart Foundation said that it was pretty much confirmed that COX-2 inhibitors did increase risk of heart attacks, "Doctors know that prescribing these drugs should be avoided in people with poor health. For now, any patients who are prescribed NSAIDs should be reassured that the results indicated a very low incidence of heart attack," he said. The researchers, Hippisley-Cox and her colleague Carol Coupland said that treatment should not be changed on the basis of their study. "Further research should be done to either reassure us that these drugs are entirely safe or to find out what the risks are so that people can be properly informed," Hippisley-Cox asserted.

Meanwhile, doctors have come down strongly at this report and have asked people not to panic over its implications, Dr Hamish Meldrum, chairman of the British Medical Association's GPs committee, said, "Patients should be reassured that although this study raises some questions there is no need to panic. And patients should not suddenly stop taking their medicines. These drugs have a long and proven safety record and have been the subject of many trials, which have not shown any increased risk of heart attacks. If patients are really concerned they should make an appointment to discuss their treatment with their doctor the next time their medicines are due for renewal."

Widely used painkillers may carry a significant risk of heart attack, according to a British analysis that raises questions about the safety of ibuprofen and other drugs in its class.

The drug family is known as nonsteroidal anti-inflammatories, or NSAIDs, prescribed for pain and inflammation. More arthritis patients recently began taking NSAIDS after fleeing related medications -- COX-2 inhibitors -- because of their link to heart attack and strokes.

Now, researchers in Britain have found a 24 percent increased risk for a first heart attack among people taking ibuprofen and a 55 percent elevated risk among those taking the prescription NSAID diclofenac. The research also confirmed earlier U.S. studies about the risks of COX-2 inhibitors, showing a 21 percent increased risk for a first heart attack among patients on Celebrex and a 32 percent increased risk for those taking Vioxx. Naproxen, an NSAID sold as Aleve, showed a slight increase in heart-attack risk, but the data was not clinically significant, researchers said.

Merck and Co. voluntarily withdrew Vioxx, a COX-2 inhibitor, from the market in September after researchers found the drug doubled the risk of heart attacks and strokes.

"We think that enough concerns exist to warrant a reconsideration of the cardiovascular safety of all NSAIDs," said Julia Hippisley-Cox, lead investigator of the British study and a professor of epidemiology at the University of Nottingham. Her analysis is reported Saturday in the British Medical Journal.

Risk for the 9,218 patients rose in the three months they were prescribed NSAIDs prior to their heart attacks compared with the 86,349 controls who hadn't taken the drugs in the previous three years.

The observational study suggested a need for further study of certain NSAIDs. Ibuprofen is sold as Advil and Motrin; diclofenac as Voltaren.

Dr. David L. Brown, chief of cardiovascular medicine at Stony Brook University Hospital, said evidence continues to mount against certain NSAIDs. Patients treated with ibuprofen or diclofenac should discuss it with their physicians, he said.

Arthur Levin, director of the Center for Medical Consumers in Manhattan, said NSAIDs run the gamut from those that act chemically more like aspirin to those that act more like COX-2 inhibitors.

Swiss medical experts who critiqued the study found flaws, noting the results should be interpreted with caution. "The quality of the data on cardiovascular risk factors and other potential confounders was poor."

U.S. Food and Drug Administration officials advised consumers to read information about the medications on its Web site, which indicates that preliminary studies on some NSAIDS show there may be safety concerns. However, the FDA said the drugs are generally safe when used according to instructions.