Common Painkillers Shown to Increase Risk of Heart Attack

The common painkillers, NSAIDs, have been linked to an increased risk for heart attacks, according to a large international study conducted by the University of Oxford’s Clinical Services Trial Unit.

NSAIDs, or “nonsteroidal anti-inflammatory drugs” are common over-the-counter pain medications and include aspirin, ibuprofen, diclofenac, and naproxen, among others. They are among the most commonly used drugs in the US, with approximately 17 million prescriptions written each year. This number is significantly greater when taking into account the vast numbers of over-the-counter purchases.

Ibuprofen Tablets
Ibuprofen and other NSAIDs may increase the risk of heart attack and other cardiovascular problems.

Researchers studied over 120,000 participants in meta-analyses of 280 previous trials of NSAIDs versus placebo studies and examined the occurrence of major vascular and coronary incidents as well as stroke, mortality, heart failure, and upper gastrointestinal complications. Vascular incidents included non-fatal heart attacks, non-fatal strokes, and vascular death. Coronary incidents included non-fatal heart attacks and coronary death.

The study found that high (but common) doses of ibuprofen and diclofenac increased participants’ risk of experiencing a heart attack or stroke within one year from 0.8 percent to 1.1 percent. Naproxen, on the other hand, did not appear to increase cardiovascular risks.

Vioxx, a COX-II inhibitor used to treat arthritis pain, was pulled from shelves in 2004 when similar findings for increased risk of heart attacks were discovered.

This finding is important for pain sufferers, particularly those suffering from arthritis. Despite the known negative side effects of NSAIDs, such as increased gastrointestinal and cardiovascular risks, arthritis sufferers commonly take NSAIDs to manage their pain. While NSAIDs are fairly safe when taken occasionally, arthritis sufferers may take them daily or more. This study’s findings add one more reason for the advancement of safer arthritis treatments.


Pain sufferers can rest assure of the safety of short-term NSAID use, but may want to look into alternative pain management techniques for long-term pain management. Far too few pain sufferers take advantage of simple pain management techniques. Weight loss, for instance, can have a remarkable effect on joint pain: For every pound of weight lost, 3-4 pounds of pressure are taken off the knee and hip joints. Physical activity is also important. The Centers for Disease Control and Prevention (CDC) found that the prevalence of walking among arthritis sufferers was extremely low – an interesting finding since walking has been shown to improve symptoms, physical function, speed, and overall quality of life.

Other non-medication pain management techniques include dietary changes, massage, acupuncture, and supplement use. Pain supplements are becoming more and more common in the arthritis community since the risks of side effects are less common. Common arthritis supplements, for example, include glucosamine, chondroitin, MSM (methylsulfonylmethane) and hyaluronic acid (HA), among others.

Due to lack of effectiveness studies, none of these supplements are approved by the FDA. However, annual sales in the industry paint a different picture of the effectiveness, with over $11.5 billion in annual U.S. supplement sales and arthritis supplements being one of the most purchased supplement categories. While studies are limited and have yet to show substantial effectiveness, consumer purchases show that sufferers are finding some relief from pain supplements.

The study’s abstract can be found here.

Kim Alexander

Advocate of arthritis research and education.

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