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Headlines & your health: cardiac safety may differ among NSAID pain relievers.

Nonsteroidal anti-inflammatory drugs (NSAIDs) carry warnings on their labels about increased risk of heart attacks and strokes. Now, a study published online June 8 in Circulation: Cardiovascular Quality and Outcomes suggests that different NSAIDs have different degrees of cardiovascular risk.

Researchers analyzed the medical records of more than 1 million healthy Danish NSAID users (median age 39) to assess the cardiovascular risk of the traditional NSAIDs diclofenac (Cataflam, Voltaren), ibuprofen (Advil, Motrin) and naproxen (Aleve, Naprosyn), and the COX-2 inhibitors celecoxib (Celebrex) and rofecoxib (Vioxx, pulled from the market in 2004).


They found that users of diclofenac faced a 91 percent increased risk of a fatal heart attack or stroke, compared to non-NSAID users, while rofecoxib use was associated with a 66 percent increased risk of cardiovascular death compared to non-use. The risk increased with higher doses of these drugs.

Similar to findings from earlier studies, the researchers reported that naproxen appeared to have the lowest cardiovascular risk. The study provided no conclusive results regarding the safety of celecoxib (Celebrex), but did show a positive trend toward increased cardiovascular risk, the study authors noted. Ibuprofen, especially at higher doses, was associated with a slightly greater risk of stroke, according to the study.

The researchers concluded that physicians "should always make an individual assessment of cardiovascular risk and carefully consider the balance between benefit and risk before starting treatment with any NSAID."

Talk to your doctor about the risks and benefits of NSAIDs, especially if you have cardiovascular disease or are at greater risk of it, and carefully follow the recommended doses. Also, consider alternative treatments--such as acetaminophen (Tylenol), physical therapy, exercise and weight loss--to manage your pain.

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Title Annotation:IN THE NEWS
Publication:Men's Health Advisor
Date:Sep 1, 2010
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