Like Vioxx, Ibuprofen May Up Heart Attack Risk
Study: 'Traditional' Painkillers May Carry Small but Serious Risk
June 9, 2005 -- Ibuprofen, naproxen, and similar pain relievers raise a
person's risk of heart attack, a new study suggests.
Ibuprofen and naproxen - traditional anti-inflammatory pain relievers --
have been considered more heart friendly than the new Cox-2 type of pain drugs.
Two of the Cox-2 drugs,
increase a person's risk of heart attack.
The new study, led by Julia Hippisley-Cox, MD, MRCP, of the University of
Nottingham, England, did show that Vioxx increased the risk of heart attack by
32% when taken in the previous three months. But it also linked ibuprofen --
brand names include Advil and Motrin -- to a 24% higher risk of heart attack
compared with people who had not taken any anti-inflammatory in the last three
Diclofenac (brand names including Arthrotec, Cataflam, and Voltaren)
increased heart attack risk by 55%. Naproxen (brand names include Aleve) was
also linked to a higher heart attack risk, although the finding was not as
Previous research has shown no link between occasional use of painkillers
and heart attacks. Patients taking over-the-counter anti-inflammatory
painkillers should not take them for more than 10 days without checking with
A second study by Canadian arthritis specialist Marie Hudson, MD, MPH, found
that among elderly patients who already had heart disease, Celebrex -- a Cox-2
drug still on the market -- was safer than Vioxx and possibly even traditional
Both studies appear in the June 11 issue of the British Medical
Heart Attacks and Pain Pills
Hippisley-Cox and colleague Carol Coupland analyzed data collected from
general practices across England, Wales, and Scotland. They analyzed data from
9,218 people with first-time heart attacks and compared them to 86,349 matched
patients without heart attacks.
Those with heart attacks were much more likely to have used
anti-inflammatory painkillers regularly, also known as nonsteroidal
anti-inflammatory drugs (NSAIDs).
"The list of traditional NSAIDs seems to be comparable to the Cox-2
drugs in increasing heart attack risk," says Hippisley-Cox, "but when
you put that into perspective, the vast majority of people taking these drugs
will not be harmed by them."
Older patients are at the highest risk of heart attack and thus more
vulnerable to the increased heart risk from pain drugs. Hippisley-Cox
calculates that Vioxx would cause one extra heart attack for every 700 patients
aged 65 and older taking the drug. Ibuprofen would cause one extra heart attack
for every 1,000 patients taking the drug.
Pain vs. Side Effects
"Patients are taking painkillers because they are in pain,"
Hippisley-Cox says. "At the end of the day, we need to know the benefits
and the risks. A young patient with arthritis has a low risk, so a 30% increase
on that is quite small -- whereas that person's dreadful pain is very likely to
affect quality of life. So there is a trade-off of living without pain vs. the
risk of side effects. The message to the consumer is not to panic and not to
change treatment based on these study findings."