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Anti-Inflammatory Drugs do Promote Heart Failure

Kathleen Blanchard's picture

A new study shows that anti-inflammatory drugs do promote heart failure. The risk also increases with increased doses of the commonly sold drugs, such as naproxen and ibuprofen.

The study, published January 26, 2009 in the Archives of Internal Medicine, again shows the link between using drugs known as COX-2 inhibitors, and NSAID's (anti-inflammatory medicine). COX-2 inhibitors are drugs widely prescribed for pain, the most well known being Vioxx.

According to Dr Gunnar Gislason (Gentofte University Hospital, Hellerup, Denmark, lead study author, "Although our study is observational, and you can never exclude all confounding factors, we have very consistent results estimated using two different statistical methods. And these results are similar to many other previous studies. In addition, we see a strong dose-related response. I think the data are very convincing."

Anti-inflammatory medication and COX-w inhibitors are not the only drugs for pain that promote heart failure. The current study shows that diclofenac also increases heart failure risk. Dr. Gislason says, "This is very disturbing, as this drug is so widely used and is available off prescription in many countries."

Ant-inflammatory drugs promote heart failure by causing fluid retention, a problem that leads to difficulty breathing and increased workload of the heart for patients with congestive heart failure. Given the fact that anti-inflammatory medications promote heart failure, the researchers consider them dangerous.

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Gislason says. All NSAIDs should be prescription-only drugs. Making them available in petrol stations and supermarkets gives the impression that they are not harmful. Many heart-disease patients will not be aware that they shouldn't take them."

Gislason adds that anti-inflammatory drugs and COX-2 inhibitors are also widely used by physicians who do not seem to be aware of the danger of heart failure in their patient population - "I don't think doctors are aware of this problem. We need to raise awareness. I think the main culprits are primary care doctors, as these drugs are so widely prescribed in general practice".

The study showing further evidence that anti-inflammatory medicines promote heart failure comes from a review of 107, 092 patients hospitalized between 1995 and 2004.

A review of the patient's use of anti-inflammatory drugs showed that 60, 974 of the heart failure patients were prescribed an NSAID, and 56.9% of them died, while another 37.5% were rehospitalized for heart failure.

The study authors recommend that heart failure patients avoid anti-inflammatory drugs, unless absolutely needed. The lowest possible dose of anti-inflammatory drug should be used, for as short a time as possible.

Source: More evidence that NSAIDs are harmful to heart-failure patients
Abstract: http://www.ncbi.nlm.nih.gov/pubmed/19171810?dopt=Abstract