According to the latest research, Ibuprofen, which is the very popular over-the-counter pain killing medication, may increase the likelihood of heart problems in individuals who suffer osteoarthritis and are taking daily aspirin in order to help decrease their cardiovascular risk.
The research was published in the Annals of the Rheumatic Diseases. The authors speculated that ibuprofen may negate the cardio-protective effects of daily low-dose aspirin.
The use of ibuprofen and aspirin appeared to increase ninefold the risk of one-year heart attack and stroke in arthritis patients in comparison with patients who were taking a cox-2 inhibitor pain reliever, the researchers discovered.
"This adds more data to the fact that maybe ibuprofen inhibits aspirin in a clinically important way," explained Dr E. Scott Monrad, director of interventional cardiology at Montefiore Weiler Division in New York City. "The most comforting thing is that the event rate observed in the research, even in the high-risk arm, is still rather low," said Monrad, who was not engaged in the research.
Do not panic
Another specialist agreed that It is not yet time to panic.
"You cannot draw firm conclusions from these findings, however it raises the question that maybe we ought to do a formal study inspecting ibuprofen versus some of these other agents in people who are at high cardiovascular risk and checking whether it really does hold up," explained Dr Robert Scott III, assistant professor of internal medicine at Texas A&M Health Science Centre College of Medicine, College Station, and senior staff cardiologist at Scott & White Hospital.
Preceding research has indicated that medications called cox-2 inhibitors, as well as non-selective nonsteroidal anti-inflammatory medications (NSAIDs), increase the likelihood of cardiovascular events. The cox-2 inhibitor called Vioxx was withdrawn from the market in 2004, after the research discovered that it might increase twofold the risk of heart attacks, and the withdrawal of a second cox-2, Bextra, followed shortly after.
Not much known about aspirin connection
However, there has not been much comprehensive study in individuals who are very likely to experience cardiovascular problems and who regularly take aspirin. Aspirin thins the blood and hence it lessens the risk of heart attacks and other cardiovascular events.
Previous research has indicated that ibuprofen may impede aspirin’s heart-healthy effects.
"The majority of the data that’s been obtained in the past has been gathered on patients who do not have overt cardiac illness," said Dr Michael Farkouh, the lead author of the research and director of the Mount Sinai Heart Clinical Trials in New York City. "We really have not examined cardiac patients that carefully."
For this research, scientists analyzed the data on more than 18 000 patients over the age of 50 suffering from osteoarthritis, comparing the cox-2 inhibitor Prexige (lumiracoxib) with either ibuprofen or naproxen.
Both Ibuprofen and naproxen (brand name Aleve) are traditional NSAIDs.
The research was sponsored by Novartis, the drug manufacturer that developed Prexige.
10 percent of the partakers were very likely to experience heart attack or stroke and some were taking low-dose aspirin (70 to 100 milligrams daily).
Patients at low risk for cardiovascular disease had nearly the same number of heart attacks and strokes, no matter which medication they were taking.
Nine times greater risk
However, patients at high-risk who were taking aspirin and ibuprofen were at about nine times higher risk of experiencing heart attacks and strokes over one year as those taking Prexige.
Individuals taking ibuprofen were also at greater risk of developing congestive heart failure than patient taking the cox-2 inhibitor.
The total risk of a problem was still pretty low, with about 2.14 per cent of those in the ibuprofen group experiencing an event, against 0.25 per cent in the group taking Prexige.
The results of the research, if borne out, could be concerning, due to the fact that ibuprofen is so easily obtainable. "If cardiac patients take ibuprofen over-the-counter, that’s a hazard, due to the fact that healthcare professionals are not aware of it," Farkouh explained. "It blocks the effect of aspirin, therefore there’s more heart failure, more heart attacks, more hypertension. It’s a significant public health message."
