Ibuprofen Boosts Heart Risk in Arthritics

A study on the effects of pain-killers on arthritics with existing heart risk has found that the common pain killer ibuprofen increases the risk of such people having a heart attack or a stroke. The researchers found that for some patients, the risk might be as much as nine times higher.

The findings come in the wake of earlier research that has already shown increased risk of heart disease from common pain killers. The latest study covered more than 18,000 people, each of whom was taking one of three pain killers – lumiracoxib, ibuprofen or naproxen – for their arthritis. While lumiracoxib is a cox-2 inhibitor type of drug, ibuprofen and naproxen are both non-steroidal anti-inflammatory drugs, also known as NSAIDs.

The study was conducted by researchers at the cardiovascular institute, Mount Sinai School Medicine, New York. The researchers found that 3,042 patients were at high risk of cardiovascular events. Of these 623 were taking ibuprofen for their arthritis pain. Half of these patients were also taking aspirin.

Overall the researchers found one in 10 patients at high risk of heart attack or stroke. Among these patients, some were also taking low dose aspirin in addition to one of the pain killers for arthritis. Patients taking both aspirin and ibuprofen were found to be at the highest risk – nine times greater – over a period of one year. This was in comparison to patients who were taking just a single painkiller – lumiracoxib – alone.

Reporting online in the journal Annals of the Rheumatic Diseases, the researchers led by Dr. Michael E. Farkouh say their findings match earlier research that has shown that ibuprofen interferes with the effects of aspirin when it is taken to prevent blood clots. This is however the first time this effect has been shown in arthritis patients.

The study also found that there was no difference in the total number of heart attacks or strokes among patients who were at low risk of such an event. The painkiller they were taking did not matter. The increase in risk was observed only for those who were already at high risk of a heart attack or stroke.

Even in this group, patients who were not taking any aspirin but were just on lumiracoxib faced a higher risk than those just on naproxen. Ibuprofen as a single medication did not add to the risk in such patients.

Prof. Alan Silman, Medical Director of the Arthritis Research Campaign said, “This is now a very complicated story. It is not just a simple relationship between ibuprofen and the risk of heart disease alone. It should be noted that people in the trial were taking very high doses of ibuprofen a day (2.4g). Very few people would be taking that amount and there is no evidence at all that at low doses ibuprofen is harmful.”

“But there does seem to be this relationship between ibuprofen and aspirin. This is the unexpected finding. You might be losing the protective benefits of aspirin if you also take ibuprofen,” he said.

Prof. Silman also felt patients already on ibuprofen without any adverse effects should not think about stopping the medication. If however they are taking low dose aspirin as well, they should consult their doctor for the same.

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