Pain Relievers May Help Bring On Heart Failure
April 11, 2000 (Atlanta) -- Common pain-relieving drugs such as aspirin,
ibuprofen, and Aleve may be responsible for putting many older people in the
hospital with heart failure, a new study shows.
Congestive heart failure, usually due to a heart attack or virus, is a
condition in which the heart is too weak to pump blood to the rest of the body.
It causes severe shortness of breath, swelling in the legs, and chest pain.
So-called non-steroidal anti-inflammatory drugs (NSAIDs) such as aspirin,
ibuprofen, and Aleve, which are often used to treat arthritis, are known to
increase blood pressure by causing a narrowing of the blood vessels in the
body. This leads to more stress on the heart, and can cause an attack of
congestive heart failure.
The researchers looked at more than 1,000 hospital patients, with an average
age in the mid- to late 70s. Of these patients, 325 had been admitted with
heart failure; the rest were admitted as emergency room cases.
Researchers found that those patients who had taken anti-inflammatory drugs
within the last week were twice as likely to be in the hospital because of
heart failure than those who hadn't. Even more astounding was that patients who
already had heart disease were more than 10 times as likely to have suffered an
attack of heart failure if they had taken these drugs.
While these drugs aren't responsible for creating the heart condition,
"the effect ... has been to accelerate the problem," says study author
John Page, of the Centre for Clinical Epidemiology and Biostatistics at the
University of Newcastle in Australia.
There is no evidence that anti-inflammatory drugs damage the heart, Page
says. But he adds that the more of these drugs people took, the more likely
they were to have heart failure. Page says that the drugs were the cause of
almost 20% of the attacks seen in the study.
"This is an issue all the time," Gregory Ewald, MD, tells WebMD.
"We've seen some people, just like this article described, deteriorate and
end up requiring hospitalization." Ewald, an associate professor of
medicine with the heart failure/transplant program at St. Louis' Washington
University, was not involved in the study.
Because many of these anti-inflammatory drugs are available over the
counter, doctors don't always know their patients are taking them. Ewald says
patients must make sure to tell their doctors if they use these medications, so
they can help prevent an attack of heart failure.
As an alternative to anti-inflammatory drugs, Ewald suggests Tylenol
(acetaminophen), since it does not have the same effect on the blood vessels
and blood pressure.
Despite these findings, Ewald tells WebMD that the benefits of aspirin,
which is often taken to help prevent heart attacks, outweigh its potential side
A couple of earlier studies have shown that people who took aspirin did not
benefit as much from drug treatment of heart failure as those who didn't, Ewald
says. "But it's hard to take that information and say you shouldn't take
aspirin. ... There's enough benefit from aspirin that we continue to treat
people [with heart disease] with aspirin, even in the face of heart
- New research shows that older people who take drugs such as aspirin or
ibuprofen may have double the risk of having congestive heart failure.
- Because these products are available over the counter, many physicians may
not know their patients are taking them.
- As an alternative, people can take Tylenol (acetaminophen) for treatment of
pain. But one observer points out that aspirin's benefits may outweigh its side