Widely used OTC drugs increase stroke risk in healthy people

October 4, 2010 by  
Filed under HEART AND STROKE

The latest class of drugs whose safety is being questioned are the so-called nonsteroidal anti-inflammatory drugs (NSAIDs). You may not know it but you probably have taken NSAIDs at least once in your life. NSAIDs are widely used both as over-the-counter (OTC) and prescription drugs. Do the names aspirin, ibuprofen and rofecoxib ring a bell? Well, these are the most well-known NSAIDs.

NSAIDs are supposed to be safe and non-addictive with very few side effects. Until the results of this Danish study was published recently that reported that short-term use of NSAIDs can increase the risk for stroke, especially ischemic stroke, even among those without any history of cardiovascular disease. The study was presented at theEuropean Society of Cardiology (ESC) 2010 Congress last week.

According to study author Dr. Gunnar Gislason:

“First we found an increased risk of MI with NSAIDs. Now we are finding the same thing for stroke. This is very serious, as these drugs are very widely used, with many available over the counter. We need to get the message out to healthcare authorities that these drugs need to be regulated more carefully.”

The NSAIDs analyzed in the study were ibuprofen, diclofenac, naproxen, celecoxib and rofecoxib. Most of these are used as analgesics and anti-inflammatory agents. Diclofenac (86%) was associated with the highest increase in stroke risk, followed by celecoxib whereas ibuprofen was associated with lowest but still significant increase in risk (30%) among the drugs analyzed. The study participants were healthy individuals who did not have underlying cardiovascular problems.

So how do NSAIDs increased cardiovascular risk?

There have been several hypotheses about the mechanism linking NSAIDs with cardiovascular events, including increased thrombotic effect on platelets, the endothelium, and/or atherosclerotic plaques; increasing blood pressure; and effect on the kidneys and salt retention.

The authors believe that the results of their have “massive public-health implications”. However, it is unlike that the use of NSAIDs will decrease any time soon because even health care professionals are reluctant to limit prescription of these drugs.

“The problem is that we don’t have randomized trials, and it is very hard to change the habits of doctors. They have been using these drugs for decades without thinking about cardiovascular side effects.” says Dr. Gislason, whose group was able to convince Danish health authorities to declare diclofenac as a prescription-only drug. However, diclofenac and other NSAIDs are available as TOC drugs in many countries.

Pain relievers: do they or do they not prevent Alzheimers?

June 25, 2009 by  
Filed under ALZHEIMER'S

old_man_and_dovesPrevious studies have reported that pain relievers such as the anti-inflammatory drugs (NSAIDs) may prevent the onset of Alzheimer’s disease. This study by American researchers, however, shows a different story.

The researchers looked at 2,736 members of Group Health, an integrated healthcare delivery system, who did not have any form of dementia when they were enrolled in the study. The average age of the study group was 75 years. The researchers then tracked these patient for 12 years, monitored their use of NSAIDs, both as prescription and over-the-counter (OTC) drugs, and their likelihood of developing dementia especially Alzheimer’s disease.

In the study group, 351 participants had a history of heavy NSAID use at the start of the study. Over the follow up period, another 107 participants became heavy NSAID users. “Heavy use was defined as having prescriptions for NSAIDs at least 68 percent of the time in two years.

The results of the monitoring for dementia gave the following results:

  • 476 participants developed Alzheimer’s disease or dementia during the study period.
  • Heavy NSAID users were 66% more likely to develop dementia compared to those who use little or no NSAID.

According to study author Dr. Eric B. Larson, executive director of Group Health Center for Health Studies.

“Although we hoped to find a protective effect, there was none. Thus, for this age group, there’s no basis for taking NSAIDs to prevent Alzheimer’s disease. Our study in this quite elderly population showed more risk of dementia with NSAIDs, especially when used heavily.”

The study results indicate a need to re-evaluate earlier research findings that suggested that NSAID use can delay or even prevent onset of Alzheimer’s disease.

There were, of course, key differences between previous studies and this study. For one thing, the study participants in this study are on average older. This could have a big influence on the results considering that dementia and Alzheimer’s disease are basically an elderly disease, even though there are cases of early onset.

NSAIDs such as Ibuprofen are available over-the-counter are popularly used as anti-fever drugs and pain relievers. In the older population, NSAIDs, marketed in the US as Advil, Motrin and Aleve, are used as pain relievers especially among those who suffer from arthritis. Recently, the US FDA has issued new labelling requirements for OTC drugs including NSAIDs, which should provide warnings about safety, including interaction between NSAIDs and alcohol.

 

Photo credit: stock.xchng

Cod Liver Oil Against Rheumatoid Arthritis

March 26, 2008 by  
Filed under ARTHRITIS

I have been on fish oil supplementation since (I think) the last half of October 2007.

I think I’ve mentioned that here, at least a couple of times. I felt the benefits right away, even before the beach/sand therapy worked on me.

Now, according to a UK study, intake of cod liver oil significantly reduced the amount of NSAIDs (non-steroidal anti-inflammatory drugs) that rheumatoid arthritis sufferers have to take in.

Taking cod liver oil could allow arthritis sufferers to cut back on potentially dangerous drugs, according to a new study.

The research could offer new hope to the about 500,000 people in Britain with rheumatoid arthritis.

Scientists believe it could allow hundreds of thousands of sufferers to scale down their use of anti inflammatory drugs, the most common treatment for the disease.

Although they ease pain, the drugs can cause side-effects such as high blood pressure and can increase the risk of a heart attack.

Because of the risks, doctors have traditionally limited their use and patients are advised to take the drugs only for short periods at a time.

But many sufferers are forced to take the pills on an almost constant basis to cope with the pain of their condition.

Cod liver oil could allow them to cut their use of the drugs by a third, the research shows.

Scientists in Dundee and Edinburgh followed 97 adults with rheumatoid arthritis, half of whom took 10g of high strength cod liver oil every day and half of whom took a placebo.

Read the full report from the UK Telegraph.

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NOTE: The contents in this blog are for informational purposes only, and should not be construed as medical advice, diagnosis, treatment or a substitute for professional care. Always seek the advice of your physician or other qualified health professional before making changes to any existing treatment or program. Some of the information presented in this blog may already be out of date.