Meta-analysis confirms that NSAIDs increase risk of heart attack and stroke

Swiss researchers recently evaluated 31 different studies, involving 116,000 patients taking non-steroidal anti-inflammatory pain medications.  They concluded that taking some form of these medications (Ibuprofen [sold as Advil or Motrin], Naproxen, Celebrex, Vioxx, etoricoxib, Prexige, and diclofenac were the drugs studied) approximately doubles a patient's risk of heart attack or stroke---from about 1 patient per 100 patient years to 2 patients per hundred patient years. Certain risks may increase 3 or 4 times, depending on the medication.  The authors noted that a related medication, Vioxx, was removed from the market in 2004 because it presented an unacceptable heart attack risk.   Prexige never won approval by the FDA, but was sold elsewhere.

The reports of the meta-analysis relate that the particular risk varies depending on the particular non-steroidal anti-inflammatory, with Ibuprofen carrying the greatest risk of stroke. (Three times the risk of patients not taking the medication.)  The authors also noted that the risk increases with increased dosage or prolonged treatment periods.  The actual study is reported in the January 11 edition of the British Medical Journal.  Naproxen appeared to be the least harmful of the NSAIDs, and experts note that the absolute risk of using the medication may be outweighed  by quality of life issues in certain chronic pain patients or when use is short-term or balanced by the elimination of other cardiovascular risk factors.