Common painkillers increase risk of heart attack by one-third, new study finds

[mfcorey1]

Ibuprofen is one of the most common over-the-counter pain relievers used worldwide, and researchers have long warned against its risk of heart attack and stroke.

» RELATED: Advil, Aleve, Motrin, more can cause heart attack or stroke: FDA
According to a Danish study published in the March 2017 issue of the “European Heart Journal—Cardiovascular Pharmacotherapy,” the consumption of any kind of non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen could increase the risk of heart attack by 31 percent.

“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,” Gunnar H. Gislason, author of the study and professor of cardiology, said in a news release. “The findings are a stark reminder that NSAIDs are not harmless.”

http://www.ajc.com/news/local/common-painkillers-increase-risk-heart-attack-one-third-new-study-finds/Q5m8BfdzaZlFZQlDKh8MXN/

[Sherman A1]

1. Thanks for posting

This is an important thing to get out

[PoindexterOglethorpe]

2. I have always tended to stick with ordinary aspirin as my OTC pain reliever of choice.

Of course, there are many out there who don't do well with ordinary aspirin, and it's discouraging, to say the least, that the otherwise excellent alternatives have such a downside.

[Barack_America]

44. Aspirin is an NSAID.

But also what you are supposed to take to prevent heart attacks. Which tells you there is more to this story.

[Ms. Toad]

57. It is actually in a category by itself - or is a distinct class of NSAIDs

I can't find the references a the moment, but since I have been a heavy user of both, I did some research quite a while ago. If you google "is aspirin an NSAID?" you'll find a number of references to differences between it and NSAIDS (or between it and "other" NSAIDS).

[OnionPatch]

52. I'd prefer aspirin but

it gives me horrible heartburn. I hear this is pretty common.

I have fibromyalgia but I only take painkillers on bad days. I wish there was something safer.

[still_one]

3. Specifically non-steroidal anti-inflammatory

[Rhiannon12866]

4. Great! My dentist gave me ibuprofen just today

I had a root canal.

[elleng]

5. Check the details.

I suspect 'occasional' use is not problematic. ROOT CANAL surely isn't something that happens every day, fortunately!

[Rhiannon12866]

6. Well, you've got to admit it's quite a coincidence that I read this tonight!

My impression was that it's safer. She used to give a prescription for painkillers after dental surgery, or at least offer the option, but I've noticed she doesn't do that anymore. I figured it was because addiction issues have become front page news and they're cracking down on prescription opioids. Back when I was in school, I had dental surgery that continued to cause me a lot of pain and my previous dentist (he retired and my present dentist took over his practice) prescribed Darvon!

[elleng]

8. I remember Darvon!

I have a few 'old' Acetominophen with codeine prescribed by a dentist years ago.

I use Motrin for occasional aches, but very infrequently. Guess I've convinced myself I'll survive.

[Rhiannon12866]

10. It was a long time ago, but I remember Darvon having side effects

I'd rather not take that again. This dentist used to offer Tylenol with codeine, but I noticed that doesn't happen anymore, she just gives me ibuprofen in a cup before I leave. And I already carry Advil in my purse. Fortunately, the only discomfort I had (though I have to go back, it's not done) was a cramp in my jaw from having to keep my mouth open for so long...

[Crunchy Frog]

9. Ibuprofen can be quite effective for dental pain, but not in every case.

But the dangers of short course, low dose, opioids have been greatly exaggerated, and in some instances, they are probably the safer and more effective way to control pain. The docs aren't prescribing them because they're scared of the DEA.

Probably both are relatively safe for short courses. I do suspect that there will be a significant increase in NSAID deaths, as the opioid hysteria continues unabated.

[Rhiannon12866]

13. I started out with an abscessed tooth and I found that Tylenol helped the most with that

And that's what I meant, that doctors are afraid of prescribing opioids, these days. Back in the '90s, I had major surgery and the doctor I followed up with had me on a prescription for Tylenol with codeine for quite a long time because I continued to be in pain. Eventually, he said that he wasn't worried about the codeine, but about the long term effects of the Tylenol. He actually detoxed me off the Tylenol, while I continued to take the codeine until I had another surgery that finally ended the pain.

[Crunchy Frog]

16. I had a series of tooth abcesses when I was a teenager in the late 70s to

early 80s, probably a result of injury to my tooth roots when I got hit by a car at age 12. They were agonizingly painful, but the Tylenol 3 (Tylenol with codeine) took care of the pain really effectively.

Motrin was a brand new miracle drug, and a dentist once tried prescribing that to me instead. Absolutely worthless for that level of pain. I know that nowadays I would be expected to simply suffer through that kind of pain. I won't, though.

[Rhiannon12866]

19. I was out of town when I got the abscessed tooth and the pain was really bad

I read the labels and toothache was mentioned on the Tylenol, so that's what I tried, but you're right, it didn't help all that much. And I do remember her prescribing Tylenol with codeine, or at least offering it, but that would have been in the '90s. My impression was that things had changed.

[Alice11111]

29. Coincidence here too. I had an epidural today, and had been taking various NSAIDS for over 2 months

I had researched the side effects, but my got when you are in pain! I was seeing lots of side effects and switched.

[tavalon]

7. You had a root canal and your dentist gave you ibuprofen

I would kill him or her and find a dentist who would adequately treat my pain. Root canal = Opiate.

[Rhiannon12866]

11. She used to offer Tylenol with codeine. but not anymore

I was guessing it's because they've been cracking down on doctors prescribing opioids. Fortunately, I was only a little uncomfortable, but I have to go back to finish what she worked on today...

[tavalon]

14. I would never tolerate that from any of my care givers

And if I don't like what has been prescribed, I tell them what I want and why. If I get a no without a good explanation, they get fired.

Bet you can't tell I'm a nurse? And I don't put up with shit from medical people I have hired. Remember, your relationship with your healthcare provider is one of consumer (you) and provider of service (healthcare professional.

Now, when I find a physician or a dentist who treats me like the colleague that I am, I hold on to them. I am a very loyal person in those cases. I have found that non- medical people have a tendency to let their doctor play parent and the patient just does whatever the doctor/dentist says. Not me.

[Rhiannon12866]

17. I've seen this dentist for quite a long time and I trust her

When my Dad had cancer, she really went to bat for him, insisted that he had necessary work done before they rushed him into chemo and when his salivary glands were destroyed by the chemo, she did all kinds of research looking for something that would help his dry mouth. I'm sure if I was in real pain, I could talk to her about it, though today my biggest discomfort was a cramp in my jaw from having to keep my mouth open for so long. In fact, I can still feel it, though I should probably avoid more ibuprofen tonight.

[tavalon]

18. Yeah, that's context that would matter

[Rhiannon12866]

20. When the dentist I'd seen since I got teeth retired, I intended to find a dentist who was closer

I now live almost an hour north and I had to take a day off from work just to go to the dentist. But my Dad thought so much of this dentist, I decided she was worth it and I haven't regretted it. I know some people are freaked out by going to the dentist, but I'm not one of them. My big worry today was the drive since I'm in New York and we're still dealing with cleaning up from Tuesday's storm.

[tavalon]

21. I'm a complete dental phobe

Luckily I have found a colleague who understands and asks ahead of time what accommodations I need. I have a scrip right now for a calming substance as I have to have two crowns replaced. He will send me home with a small prescription for itchy opiods. He'll also likely have me use clove oil. He may even suggest ibuprofen after.

I'm not worried because he is kind, competent and thoughtful. Trifecta!

[Rhiannon12866]

24. Sounds like you have a really great dentist!

I have one, too, which is the reason I'm willing to make the drive. Dentists are definitely not all alike. When I was still a kid, we moved, and my brother was seeing another dentist closer to home. Seems like he was always getting fillings, while I continued to see the regular dentist since I only went twice a year. But then I was going away to camp and my mother took me to see the dentist who my brother had been going to and he said I had 9 cavities! My mother freaked out and took me to see the dentist I'd always seen and he said I had one! He checked out my brother and said that this new dentist had been filling "worn spots" which might or might not turn into cavities!

So that's why I'm really loyal to my dentist, won't just go to anybody. And I do understand that it's not uncommon for people to have issues with dental work. My aunt saw the same dentists we did and I learned that she was prescribed Valium just to get her through it. And I'm guessing he must have seen a dentist by now, but my financial advisor, who I have known since the '90s, hadn't gone back to the dentist since 1974!

[tavalon]

25. You would be amazed.

I'm obsessed with my oral hygiene and I go twice a year. This year I got bad news but with my guy on my side, I can face it. A good medical professional is worth their weight in gold. A bad one, worth firing. I'm glad we both have good ones.

I had a really skilled (best in the MW) kidney surgeon in case one of my kidneys needed to be removed (long story). But he was a dick and when I found out he threw a scalpel at a scrub tech, I was going to very publicly fire him. Alas, he retired. I still make sure everyone in the office remembers just how awful a being he was. The one I got turfed to, I like.

[Rhiannon12866]

27. I'm awfully glad you have someone you can trust

I know how that is. When I was having serious health issues back in the '90s, I ended up going to Mass General in Boston because all they were offering up here was surgery and I was scared to death. I did end up having surgery in Boston, but my surgeon (also another woman) came highly recommended and I felt I could trust her and she knew how I felt. It really does make a difference...

[Alice11111]

31. I think I will travel across country to your dentist. I've been through a nightmare for 1&1/2 years,

which started with a simple chipped crown. Still going. I had near perfect gums. Now bone grafts, implant, grinding out implant, 5 front teeth removed, disfigured, severe gum loss over those teeth, and the costs of a new Lexus later, not to mention the radiaton and other damaging drugs, chemicals, embarrassing orange ugly temps that have to be glued in constantly, and allergies. Haven't been able to bite a fruit or much besides soft blah for all that time. I've had consults with multiple dentists together and many referrals in an effort to clean this up. 11 dentists. It all started with good gums, a chipped front crown, and a gal, who has always taken excellent care of her teeth.

Your drive is worth it!!!!

[Rhiannon12866]

36. I'm so sorry you've had to go through all that!

All my brother has from going to the wrong dentist is a mouth full of silver. She's in Albany, New York. I'm quite sure you would like her, she's experienced and kind. I believe she started her career in the Navy. My previous dentist sent me to a specialist when I needed a root canal, she's capable of doing everything herself.

And she's "one of us!" I had a dentist appointment with her on 9/11. It was only for X-Rays, but it seemed like it took forever, the TV was on CNN and everyone was gobsmacked. And that was the day that I woke up and decided I'd better pay more attention to what was going on in this country - and the world. I found DU early in 2003 and I've learned so much. I mentioned that once before here and another DUer said I should mention it to my dentist, so I did. And it turns out that she's also a liberal, I never knew!

So now I feel comfortable mentioning politics, in fact, when I was there today I showed her a cartoon someone had posted on DU! Have I sold you yet?

[Alice11111]

38. Thank you. Definitely sold.I always feel more comfortable with like souls, who are usually competent

[Rhiannon12866]

39. Hoping to avoid surgery, I saw an acupuncture doctor for awhile

He was am MD, very competent in more than one field. and he used to advise me who to vote for. i realize now he was a liberal, too.

[Alice11111]

40. I hope you can! Acupuncturists can be amazing.I had aChinese one at the Mayo Clinic who fixed a knee

that was dislocated and cracked. I really couldn't believe it. That's bones, not soft tissue, and I didn't expect the highly qualified doctors at Mayo to have an acupuncturist on staff. I guess really good docs get the best, without prejudice. It lasted for 3 years, and I am a mountain hiker.

I'm trying to avoid surgery too with epidurals, and I get to start acupuncture in two weeks.

[Rhiannon12866]

41. Oh! Very cool!

That doctor sounds amazing! I decided to try it out of desperation, but my doctor thought outside of the box. It didn't cure me, in fact he was the one who convinced me to have surgery, but I saw him for follow up and he helped the healing which was tough. He was a great advisor and kind, besides having experience, had practiced as a pediatrician and then a psychiatrist before he went into alternative medicine!

And since it helped me, I took my 18-year-old cocker spaniel for veterinary acupuncture when he could no longer get around. I knew it was non invasive, and he walked again comfortably for the rest of his life...

Wishing you all the best with yours!

[Alice11111]

43. My cat was recommended for acupuncture, but fortunately some else worked.

Sometimes it doesn't work, just like conventional medical care. It never harms though, and at worst, it is incredibly relaxing.

[Crunchy Frog]

23. When I tried to talk to my, long term, doctor about the kidney stone pain

She threw a temper tantrum and accused me of being drug seeker.

I currently don't have anyone in the medical profession that I feel I can trust, or that I can talk to openly. You're very fortunate to have someone that you feel you can talk to openly.

[Rhiannon12866]

26. That's what I meant when I said things had changed

Doctors are afraid to prescribe opioids now. Back in the '90s, I had three surgeries in seven years, went to Mass General in Boston, and surgeries #1 and #2 didn't work. I was in a lot of pain and my doctor who I followed up with at home continued prescribing painkillers for me since I really was in pain. I took Tylenol with codeine for over a year until he said he was worried about the Tylenol, that it could cause liver damage over time. So he detoxed me from the Tylenol, but continued with the codeine. Fortunately, surgery #3 worked. I don't think that would happen today...

[Warren DeMontague]

47. Anyone paying attention could have predicted this would happen

what with all the hysteria over the so-called "prescription drug crisis". People in terrible pain are treated like criminals.

Shades of Richard Paey.

Yay, drug war!

[Rhiannon12866]

48. I know!

And when people are desperate, they'll go to any lengths. I remember what it's like to be in pain. Taking away a lifeline is as cruel as it gets. Not everyone is an addict.

[Alice11111]

30. Frankly, I've had too much experience with dentists &med professionals, &I find most are incompetent

which they try to cover with their arrogance. Arrogance is also used to intimidate patients from asking questions about which they know less than the patient and to aviod having to spend time w the patients.
I have many close friends and family who are doctors, and a few are saints. I've represented docs, and, geez, they get nasty with each other...try to ruin careers.

Today, I had a back epidural by a very competent lady who has treated me before. All the support staff were wonderful!

[Crunchy Frog]

12. I had a root canal relatively recently, and the ibuprofen worked fine.

On the other hand, it was absolutely worthless for the kidney stone that I had 2 years ago, and for which I received essentially no meaningful pain management, and was treated worse than an animal by so called medical professionals.

Fortunately, I've learned that there are other ways of procuring opiates, and I've got all the access that I need for any future kidney stones, really severe dental pain, or any other severe pain for which NSAIDS are inadequate. It's not an ideal situation, but if the medical community refuses to effectively treat severe pain, taking matters into your own hands may be the only sensible alternative.

I don't intend to ever again spend hours lying in an ER screaming in pain while being insulted and told to shut up by hostile staff members. Fuck that.

[tavalon]

15. And right here is the reason the black market works

Because the people who should be providing the care, suck, don't care, whatever.

As an aside, when picking your opiod for a given pain, make sure you aren't ordering one that could cause spasmodic episodes and think about the way the medication is metabolized. Basically, we the not helpful medical professionals are dumping on you to find the right medication. It's fucking stupid.

[Crunchy Frog]

22. I won't go into specific details, but there's no black market involvement

and it's not medication in the strictest sense. It's crude, and needs to be used carefully and cautiously, but it will handle severe, acute pain in a pinch. I also have a decent stockpile of kratom for when I need more than an NSAID but less than the other stuff.

I wish that I had a choice of commercially produced opioids, but I don't, so must utilize what I've got.

I guess in the current medical climate, it's back to the old standbyes. Fortunately, I haven't had a pain situation since the kidney stone that required more than ibuprofen, and hopefully that will remain the case. It's a relief though to know that I have backup, just in case something does happen.

[Alice11111]

34. Research anything they tell you yourself. Epocrates. Drugs.com. Mayo Clinic. Johns Hopkins.

Good medical schools. European and US Medical Journals. Sometimes, European and British medicine is years ahead of ours, as they don't have as many constraints and as much money pushing back. Dont go to religious sites or internet quacks and junk. Some of the blogs are helpful, but know what to ignore, like any blog.

I saved myself from a debilitating surgery, recommended by 3 teams in the US by reading med journals. Europe had banned the surgery. Then, 2 years later, Johns Hopkins banned it. Now, it is illegal in the US. There are attorneys advertising everywhere to call if you had.... There is no compensation worth your quality of life.

[panader0]

65. I had twenty teeth pulled on Dec. 27th

I now have great new dentures and the AZ AHCCCS paid for almost all of it.
The dentist gave me Tylenol with codeine, but after two or three days I didn't
need them. A few years ago when I fell drunkenly into a ditch and broke ribs in my back
I asked my friends for opiates--that really hurt. Thanks me.

[Warren DeMontague]

46. Unfortunately, it's probably less about patient safety, and more about the DEA

It's fucking bullshit. Ibupofren is great but for most of us severe dental pain - root canals, surgery - warrants actual opioids.

And pain patients are suffering, not because it's good medicine and pain management, but because authoritarians are in perpetual panic that someone might catch an unauthorized buzz off the pills.

[colorado_ufo]

28. Tylenol (acetaminophen) can be extremely toxic to the liver.

ONE overdose is capable of wiping out a liver. In careful doses, though, it is safe. Beware of taking it with alcohol.

[Alice11111]

35. My dad lost his kidneys with tylenol. It was the miracle drug then, when aspirin was dangerous.

[Mariana]

54. Somehow those cases don't make front page news.

You know what else I haven't heard much about? The dangers of combining alcohol with narcotics. That combination is particularly deadly. I wonder how many of the overdoses during the current "crisis" have involved alcohol.

[tavalon]

60. it is one of the most dangerous drugs available over the counter

[pansypoo53219]

32. i am so glad i found out that table pepper sniffed to sneeze is great for pressure headaches.

local honey for hay fever.

[chillfactor]

33. I occasionally take Ibuprofen...

for relief from my arthritis....nothing else works for me and I have tired everything. I have it per prescription from my doctor. The pills bring me great relief......I could not live a normal life w/o them.

[Alice11111]

37. Sometimes, the reality is that you just have to balance it out, and NSAIDS may be the best solution.

Always take with food or a proper drug to mitigate the ulcers they cause.

[roamer65]

62. I take an ibuprofen and acetominophen for arthritis.

That way I am not overloading on one or the other. A doctor recommended it to me and it works well for me. Each one acts differently on pain and I get a better pain kill as a result.

[MFM008]

42. I'll risk

Liver with Tylenol
Over heart.

[Alice11111]

45. MfCorey, thanks for setting up this thread! Important!...and there are political overtones.

[Saboburns]

49. I got to chime in here

Ibuprofin is the culprit here in regards to heart attacks. Not all NSAIDS, such as acetaminaphin or Naproxen. I felt this needed to be pointed out as the snippet read that all NSAIDS were being painted with same brush as it pertains to heart attacks in this study.

[eniwetok]

50. 30% OVER WHAT?

Didn't read the article, but stats can be misleading.

If there's a 1% chance and it goes up to 1.3%.... that's 30%... but not significant.

[Saboburns]

51. Copy and pasted ftom study

Methods and results
From the nationwide Danish Cardiac Arrest Registry, all persons with OHCA during 2001–10 were identified. NSAID use 30 days before OHCA was categorized as follows: diclofenac, naproxen, ibuprofen, rofecoxib, celecoxib, and other. Risk of OHCA associated with use of NSAIDs was analysed by conditional logistic regression in case–time–control models matching four controls on sex and age per case to account for variation in drug utilization over time. We identified 28 947 persons with OHCA of whom 3376 were treated with an NSAID up to 30 days before OHCA. Ibuprofen and diclofenac were the most commonly used NSAIDs and represented 51.0% and 21.8% of total NSAID use, respectively. Use of diclofenac (odds ratio [OR], 1.50 [95% confidence interval (CI) 1.23–1.82]) and ibuprofen [OR, 1.31 (95% CI 1.14–1.51)] was associated with a significantly increased risk of OHCA. Use of naproxen [OR, 1.29 (95% CI 0.77–2.16)], celecoxib [OR, 1.13 (95% CI 0.74–1.70)], and rofecoxib (OR, 1.28 [95% CI 0.74–1.70)] was not significantly associated with increased risk of OHCA; however, these groups were characterized by few events.

[Hekate]

53. After 3 different Rx brands of arthritis pain reliever gave me swelling of the tongue & throat....

....I got the message and went back to buffered aspirin for occasional use. Aspirin has been around nearly forever and its side effects are very well known and so can be guarded against.

The side effects of the arthritis meds could be ignored in my daytime life, but gave me obstructive sleep apnea, which is terrifying.

The key to safety with the OTCs is no doubt occasional use, but they are vigorously peddled for daily longterm use.

[Demsrule86]

55. That is insane.

Pain kills and with the war on prescription drugs the drugs named are the only game in town... we do not need prescriptions for common pain relievers...people know the risk but sometimes the pain makes it a necessity.

[Coventina]

56. Well that's just great. I'm on maximum prescription doses of ibuprofen, and opioids are impossible

to get anymore.

So what am I supposed to take for my arthritis pain?

Tylenol doesn't do shit for me.

I'm allergic to naproxen (Aleve).

[roamer65]

63. Make sure you monitor your BP well.

Biggest side effect of the NSAID's is high blood pressure, which if untreated can cause thickening of the left ventricle of the heart.

[Hugin]

58. I've heard about this problem for awhile now.

I'm very careful taking Ibuprofen now. It used to be my go-to, but, I've also read taking it, even on the short term, can undo many of the benefits of aspirin therapy.

A shame really, as the alternatives aspirin and acetaminophen both have their down sides, too. Aspirin can cause stomach problems and blood thinning and acetaminophen with liver damage. But, neither is as immediately threatening as Ibuprofen.

:/

[Vinca]

59. Aleve works great, but I've noticed it raises my blood pressure so I try not to take anything.

[inanna]

61. Great.

I just took a Motrin (something I don't usually buy) about an hour ago to quell this throbbing head of mine.

Then I read this.

Of course!

I realize that once probably won't be an issue. But still.

[Sgent]

64. For what its worth

this paper, and others, have found Naproxen (Alieve) much safer than Ibeprofen and most of the rest of the NSAID class.

Another thing, codiene is being depreciated -- its no longer considered a good drug. It, by itself, is not a pain killer, but your body turns it into morphine. The problem is that different people turn different amounts into morphine, so it may be too effective for some and not effective at all for others. Low dose hydromorphone (the narcotic in Vicoden) is a better option.

[CTyankee]

66. I take Aleve when my arthritis is bad. It really helps, but I have to take two...