The Hidden Heart Risk in Your Medicine Cabinet
When nonsteroidal anti-inflammatory medications such as ibuprofen (Motrin, Advil) and naproxen sodium (Aleve) first hit the market, they were heralded as an attractive alternative to aspirin for tackling aches and pains, as they were thought to be gentler on the digestive tract. But in recent years, these medications, which are used for everything from arthritis to headaches and back pain, have begun to raise serious concerns about their off-target effects, particularly on the heart.
The most recent evidence was released earlier this month when a study from Copenhagen University Hospital in Denmark showed that people taking ibuprofen for a period of less than 30 days raised their risk of sudden cardiac arrest—when the heart suddenly stops pumping blood—by 31 percent in the month that followed, compared to those who didn’t take the painkiller. People who took a prescription NSAID called diclofenac had a 50 percent higher risk of sudden cardiac arrest. To reach their conclusion, the researchers analyzed 29,000 cases of cardiac arrest between 2001 and 2010, examining the use of medications in the previous month.
In another recent study, Chinese researchers found that NSAIDs increased the risk of a heart attack three-fold if they were taken orally during a respiratory infection, and much higher if by intravenous infusion. Colds and flu heighten inflammation generally, and the use of NSAIDs to reduce inflammation was previously thought to be beneficial. However, something else on top of that appears to amplify the risk of a cardiac event.
The problem may stem from the fact that NSAIDs like ibuprofen target an enzyme known as COX-2, which is responsible for pain and inflammation. However the enzyme also plays a role in regulating heart function. How this drug class hurts the heart isn’t fully known, but it may cause arteries to constrict, cause the retention of fluid, raise blood pressure or promote clot formation.
Concerns about NSAIDs and the heart are not new. In 2005 the FDA added a boxed warning about a heightened heart risk to drug labels. Accumulating data prompted the agency to strengthen the warnings in 2015.
What can you do about everyday aches as well as more chronic pain conditions like arthritis? If you have heart disease or high blood pressure, talk with your doctor before using a NSAID. If you are taking aspirin to prevent heart attacks and stroke, keep in mind that NSAIDs including ibuprofen and naproxen can interfere with that protective effect.
Try hot or cold packs or physical therapy to alleviate pain before reaching for a pill. But if you really need to take medication, do so with caution. For instance, take the lowest possible dose and never use more than the maximum recommended dose in one day. Keep in mind that serious heart events can happen even in the first weeks after starting a NSAID and the risk may increase the longer you are on it.
To lower the chances of experiencing a serious cardiovascular event, it’s important to reduce your risk factors for heart disease: Kick the smoking habit; eat a mostly plant-based diet, limit red meat, saturated fat and processed and fried foods; aim to exercise at least 150 minutes a week (about 30 minutes, five times a week) and have low LDL-cholesterol levels.
For information about blood and urine tests that may help detect hidden heart risk, go to www.knowyourrisk.com