New research shows common painkillers can pose heart risks if used long-term

What’s the first thing we do if we’ve got a nagging headache, or are suffering with stiff joints and aching bones? The fact is we reach for the painkillers. It’s become second nature to most of us. Personal trainers aren’t immune from this either. Over-the-counter painkillers are the biggest sellers in pharmacies, and the reason for that is that they work and provide relatively-safe, short-term pain relief. But what happens when you take these medications over a longer period in larger quantities? Well, various studies have flagged up some concerns among medical practitioners about the long-term effects of painkillers. The latest study published in the Lancet makes for uncomfortable reading. The research clearly demonstrates that two common painkillers, ibuprofen and diclofenac, can have an impact on long-term health if taken over a prolonged period and can slightly increase the chances of developing heart problems.

People who suffer from arthritis often take these drugs as they can relieve pain and reduce inflammation. Most will have been made aware of the potential risks of long-term usage, but will have made a judgement that the benefits of taking the drug outweighed the risks. The new research, undertaken at the University of Oxford, analysed the issue in unprecedented detail, and was geared to giving patients all the information they need to make an informed choice.

The researchers investigated more than 353,000 patient records from 639 separate clinical trials to assess the impact of non-steroidal anti-inflammatory drugs. However, they focused specifically on high-dose prescriptions levels of 150mg diclofenac or 2,400mg ibuprofen each day, rather than over-the-counter pain relief. They discovered that for every 1,000 people taking the drugs there would be three additional heart attacks, four more cases of heart failure and one death as well cases of stomach bleeding – every year as a result of taking the drugs. The increase may sound insignificant, but it was still a sufficiently worrying increase to trouble lead researcher, Prof Colin Baigent. He told the BBC’s health editor:

“Three per thousand per year sounds like it is quite a low risk, but the judgement has to be made by patients. So if you’re a patient and you go and sit in front of your doctor and discuss it, you are the one who should be making the judgement about whether three per thousand per year is worth it to allow you, potentially, to go about your daily life.”

He reaffirmed that the study’s conclusions should not be a cause for concern for people taking a short course of these drugs to deal with things like headaches, however, he did warn that those already at risk of heart problems would be at even greater risk as a result of the high-dose drugs. The problems would be further compounded and produce even greater risks for people who smoked or were overweight:

“The higher your risk of heart disease; the higher your risk of a complication. Roughly speaking, if you’ve got double the risk of heart disease, then the risk of having a heart attack is roughly doubled.”

Official figures show that there are more than 17 million prescriptions of non-steroidal anti-inflammatory drugs in the UK each year. Two thirds of the tablets prescribed are either ibuprofen or diclofenac. A newer drug, naxopren, is now often prescribed by doctors to higher-risk patients because it has lower risks of heart complications. The drug does a similar job to aspirin by stopping the blood from clotting; however this also increases the odds of a stomach bleed.

Prof Alan Silman, medical director of Arthritis Research UK, said ibuprofen and diclofenac provided a lifeline for millions of people suffering with arthritis and were extremely effective in relieving pain. However, he added:

“Because of their potential side-effects, in particular the increased risk of cardiovascular complications which has been known for a number of years, there is an urgent need to find alternatives that are as effective, but safer.” Prof Donald Singer, member of the British Pharmacological Society and from the University of Warwick, told the BBC:

“The findings underscore a key point for patients and prescribers – powerful drugs may have serious harmful effects. It is therefore important for prescribers to take into account these risks and ensure patients are fully informed about the medicines they are taking.”

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