Drugs like aspirin, ibuprofen (Advil, Motrin), and naproxen (Aleve), all have one thing in common - other than the fact that they can relieve a killer headache. These drugs are all classified as NSAIDs, nonsteroidal anti-inflammatory drugs, and while they are available over-the-counter, no prescription needed, there is some concern in the scientific community that these drugs may be linked to a risk of cardiac arrest.
"Allowing these drugs to be purchased without a prescription, and without any advice or restrictions, sends a message to the public that they must be safe," said Professor Gunnar H. Gislason, author of a new study published in the European Heart Journal - Cardiovascular Pharmacotherapy. "Previous studies have shown that [they] are related to increased cardiovascular risk which is a concern because they are widely used."
Experts in Denmark investigated the potential link between NSAID use and cardiac arrest, including nearly 30,000 people suffering out-of-hospital cardiac arrests. In Denmark, ibuprofen is the only over-the-counter NSAID prescription available, and more than three thousand of these patients reported taking NSAIDs up to 30 days before their cardiac arrest.
"The findings are a stark reminder that NSAIDs are not harmless," said Professor Gislason. "Diclofenac and ibuprofen, both commonly used drugs, were associated with significantly increased risk of cardiac arrest. NSAIDs should be used with caution and for a valid indication. They should probably be avoided in patients with cardiovascular disease or many cardiovascular risk factors."
A 2013 study completed by Canadian pharmaceutical experts urged doctors and patients to consider the balance between NSAID benefits and risks, especially for patients with known heart conditions or predispositions to disease. In certain situations, use of NSAIDs can lead to platelet aggregation and blood clot formation, events which are both capable of increasing blood pressure and the risk of adverse cardiac events, like cardiac arrest.
Gislason’s study shows that NSAID use is associated with a 30 percent increase in risk of cardiac arrest, but do not go throwing out all of your Advil Liqui-Gels just yet. More research must be done to describe the full profile of risk that comes from NSAID use, including the amount of drug used, how often a drug is used, the health status of the person using the drugs, and many more factors. However, for now Gislason has a few recommendations.
"Do not take more than 1200 mg of ibuprofen per day," Gislason explained. "Naproxen is probably the safest NSAID and we can take up to 500 mg a day. Diclofenac is the riskiest NSAID and should be avoided by patients with cardiovascular disease and the general population.”
Sources: American College of Rheumatology, Canadian Pharmacists Journal, European Society of Cardiology
