PAINKILLERS taken by millions of people in Britain every day can dramatically increase the risk of a condition which causes heart attacks and strokes.
Patients regularly taking ibuprofen to ease crippling ailments including arthritis can see their chances of an irregular heart rhythm soaring by as much as 40 per cent.
Ibuprofen is the most commonly used type of medication known as non-steroidal anti-inflammatory drugs.
A study of more than 30,000 patients found users were 40 per cent more likely to develop an irregular heart rhythm – atrial fibrillation or flutter – which can lead to a stroke, heart failure and death.
Of the nine million people in Britain who take ibuprofen each day – and at least 1.5 million who use a new class of pain reliever – more than 700,000 suffer with the condition.
Natasha Stewart, senior cardiac nurse at the British Heart Foundation, said: “This study suggests a link between common pain relief medicines and an increased risk of developing particular abnormal heart rhythms. However, it’s important to note that the overall risk from these drugs and abnormal heart rhythms is still small.”
She added: “Those most at risk were the elderly or people with other illnesses, such as chronic kidney disease or rheumatoid arthritis.”
The 40 per cent risk for users of non-steroidal drugs (NSAID) is against 70 per cent for patients who take the new class of pain reliever COX-2 inhibitors or coxibs.
She said: “Doctors are rightly already cautious about prescribing COX-2 inhibitors for people with heart and circulatory disease or at high risk of developing it.
Ibuprofen
“As with any drug, there are risks and benefits to be had. Talking these through with your GP will help ensure the benefits outweigh any risks.”
The statistics mean that seven cases per 1,000 patients on coxibs and four cases per 1,000 taking NSAIDs will develop atrial fibrillation within two months of using them. It is the latest research to highlight the dangers of the everyday painkillers.
Another widely used NSAID is diclofenac while coxibs include rofecoxib and celecoxib.
Widespread side effects include kidney damage, gastro-intestinal complications and heart damage.
Although they have already been linked to an increased risk of heart attacks and strokes, no study has examined whether they increase the risk of atrial fibrillation. In May, experts revealed that taking high-dose NSAIDs for as little as a week can increase the risk of dying or recurrent heart attack by 45 per cent. The risk rose to 55 per cent if treatment was extended to three months.
And a study earlier this year found that heart patients using the painkillers every day for a year could triple their risk of suffering a stroke.
Speaking about this latest research, lead author Professor Henrik Sorensen, of Aarhus University Hospital in Denmark, said: “Our study adds evidence that atrial fibrillation or flutter need to be added to the cardiovascular risks under consideration when prescribing NSAIDs.”
The researchers, whose findings are published online in the British Medical Journal today used a database of Danish patients to identify 32,602 with a first diagnosis of atrial fibrillation between 1999 and 2008.
They compared each one with 10 age and sex-matched controls randomly selected from the population.
Patients were classified as current or recent NSAID users while those who had their first prescription within two months of being diagnosed with an irregular heartbeat were classed as new users.
The risk of a heart flutter appeared highest in older people – and patients with chronic kidney disease or rheumatoid arthritis were at particular risk when starting treatment with COX-2 inhibitors. The researchers said the drugs could increase the risk through kidney and heart-related actions.
The research paper concluded: “We found that use of non-aspirin NSAIDs was associated with an increased risk of atrial fibrillation.
“Compared with non-users, the association was strongest for new users, with a 40 to 70 per cent relative risk increase (lowest for non-selective NSAIDs and highest for COX-2 inhibitors).” Professor Jerry Gurwitz, of Massachusetts Medical School University, reviewing the study, said a plausible biological mechanism was uncertain.
He said: “However, NSAIDs should continue to be used very cautiously in older patients with a history of high blood pressure or heart failure.”
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Painkillers including ibuprofen and common arthritis treatments can drastically increase the risk of strokes, warns a major study.
Patients taking the drugs daily are more likely to develop an irregular heartbeat – which can be deadly.
Research involving 30,000 patients found that the group of treatments which includes ibuprofen raised the risk of this complication by 40 per cent.
And a group of painkillers known as Cox-2 inhibitors, which include Celebrex and other common drugs for arthritis, increased the likelihood by 70 per cent.
Research has already shown that ibuprofen and other non-steroidal anti-inflammatory drugs, known as NSAIDs, and Cox-2 inhibitors increased the risk of heart disease.
Certain treatments have been taken off the market because the risk was so high.
But this is the first time scientists have found that the drugs raised the likelihood of abnormal heart rhythm – known as atrial fibrillation – which can lead to a stroke.
The study in Denmark looked at 32,602 patients who had been diagnosed with atrial fibrillation from 1999 to 2008.
It found that patients who had been using drugs such as ibuprofen every day within the previous two months were 40 per cent more likely to develop an abnormal heart rhythm.
Those who started taking Cox-2 inhibitors daily within the previous two months were 70 per cent more likely to develop the condition.
The study published online in the British Medical Journal found that the elderly, those with rheumatoid arthritis or with chronic kidney disease were at a particularly high risk.
It also found, however, that patients who had been on the drugs for longer than two months seemed to be less at risk than those who had just started taking them.
The exact numbers of people taking both types of drugs regularly is not known.Experts last night stressed that the risk was low.
Natasha Stewart, senior cardiac nurse at the British Heart Foundation, said: ‘This study suggests a link between common pain relief medicines and an increased risk of developing particular abnormal heart rhythms, known as atrial fibrillation or atrial flutter.
‘However it’s important to note that the overall risk from these drugs and abnormal heart rhythms is still small. Those most at risk were the elderly or people with other illnesses, such as chronic kidney disease or rheumatoid arthritis.
‘The study also noted that NSAIDs, which include ibuprofen, carried a lower risk than drugs in the COX 2 inhibitor group.
‘Doctors are rightly already cautious about prescribing COX 2 inhibitors for people with heart and circulatory disease or at high risk of developing it.
‘As with any drug, there are risks and benefits to be had. Talking these through with your GP will help ensure the benefits outweigh any risks involved.’
The anti-inflammatories, which are widely available in supermarkets and pharmacies, have been previously linked to a higher chance of heart attacks and strokes.
But a new study has shown for the first time a connection between the drugs and atrial fibrillation, also known as irregular heart rhythm or flutter.
The condition is more common than heart failure and stroke, and is linked to a higher long-term risk of developing both.
Experts examined the records of 32,602 patients with flutter between 1999 and 2009 and compared each to ten randomly selected control patients.
People who had recently begun using non-steroidal anti-inflammatory drugs (NSAIDS), which include ibuprofen and aspirin, were found to have a 40 per cent higher chance of flutter, equivalent to about four extra cases per year per 1000 people.
Newer forms of the drugs known as selective COX-2 inhibitors, were associated with a 70 per cent higher risk in new users, or seven more cases per 1000 people each year.
Older people were found to be most at risk from the drugs, and patients with chronic kidney disease or rheumatoid arthritis were particularly vulnerable when starting cox-2 inhibitors.
The threat was lower in patients who had been using the drugs for longer than two months because people who were susceptible were likely to experience symptoms early on, researchers said.
The research, published today in the British Medical Journal, was carried out using Danish medical records at Aarhus University Hospital in Denmark.
The researchers claimed the study “adds evidence that atrial fibrillation or flutter needs to be added to the cardiovascular risks under consideration when prescribing NSAIDs.”
Prof Henrik Toft Sørensen, who led the study, said heart disease patients should not stop taking the drugs but should discuss the potential risks with their doctor.
He said: “The absolute risk is still low. It increases your risk from a very low level to a higher – but still low – level.”
The team hopes to do further trials to establish which patients are most likely to experience the dangerous side effects from the drugs, he added.
In an editorial accompanying the study Professor Jerry Gurwitz of Massachusetts Medical School in the US said doctors should be cautious when prescribing NSAIDS to older patients with a history of hypertension or heart failure.
He said the research had “important clinical and public health implications” because of the high use of the drugs and the increasing threat of flutter with advancing age.