Every single day, people around us, including our self, find themselves in varying degrees of pain. This can be the result of sore or aching muscles, a bump on the head, or a change in weather that causes a headache. And being as none of the above are very significant, the typical course of action for a person with such mild pain to take commonly prescribed anti-inflammatory painkiller.
However, a new study suggests that taking these medications can increase your risk of heart attack as early as a week after starting them.
Epidemiologist Dr. Michèle Bally of the University of Montreal Hospital Research Centre and her colleagues have analyzed individual, anonymous patient data on 446,763 people in Quebec, Saskatchewan, Finland, and England to take a closer look at the risks of NSAID use. The data set included 61,460 people who had suffered a heart attack (first myocardial infarction).
In clinical trials, participants are usually assigned to take high doses of medications continuously, but Bally was interested in studying the risk associated with very short-term use of one to seven days.
“That risk was not documented previously,” she said.
In a recent issue of The BMJ (formerly known as the British Medical Journal), Bally and her team from McGill University, Finland and Germany say the risk of heart attack appeared greatest in the first month of treatment with higher doses.
“Prescribers should consider weighing the risks and benefits of NSAIDs before instituting treatment, particularly for higher doses,” the authors wrote.
So what does this mean for patients? Well, according to Bally, the results reinforce why consumers need to read NSAID drug labels and talk to their doctor.
“There’s a perception that they’re benign,” Bally said. “Please read the label. Be aware and ask your doctor about your cardiovascular baseline risk.”
Bally gives the example of a one percent risk of heart attack per year due to NSAIDs in an elderly individual with Type 2 diabetes who smokes, has hypertension and a previous heart attack and takes NSAIDs continuously for aches and pains.
“Our study suggests that one per cent increases to 1.
2 percent per year or 1.5 percent per year. That’s very low from a single person’s viewpoint. It will be like 12 people out of 1,000 or 15 people out of 1,000.”
Dr. David Henry has studied the impacts of medication use at the University of Toronto. He was not involved in the study, which he called a “very sophisticated approach to analyzing individual patient data” that emulates a large clinical trial.
“The results confirm the overall risk with NSAIDs and show its very rapid onset,” Henry said in an email.
“The recommendation to avoid in the highest-risk patients and use the lowest dose still stands. For the general public without a history and without major risk factors the risk remains very low — that hasn’t changed.”