Older Women: Some Painkillers May Raise Heart Risk
Class of drugs that includes naproxen linked to increased chance of heart attack, stroke, but finding not conclusive
Within this group of women, naproxen was the most widely used NSAID that inhibited cox-2 more than cox-1, while ibuprofen (Advil, Motrin) was the most widely used NSAID that inhibited cox-1 more than cox-2.
"Although there are other agents that are in this analysis, our findings are largely applied to naproxen and ibuprofen since they were such a wide part of our study sample," Bavry said.
The doctors found a moderately increased risk of heart attack and stroke associated with use of both selective cox-2 inhibitors and those NSAIDs that affect cox-2 more than cox-1. Use of NSAIDS that inhibit cox-1, including ibuprofen, appeared to have no effect at all on heart attack or stroke risk.
Women should discuss this research with their doctor to decide whether naproxen is right for them, Bavry said.
"Many people think that naproxen is the safer NSAID," he said. "This study is counter to our previous understanding of these agents, and signals to me that we need to further research these agents for safely treating chronic pain syndromes in women."
Antman agreed that everyone should talk with their doctor if they regularly use NSAIDs.
"Please inform your physician about all medications you take, even over-the-counter medications, and do not routinely use NSAIDs for an extended period of time," he said.
But people should be careful drawing conclusions from this latest finding, Antman added. The study was not a randomized trial, he noted, and the available data left some important questions unanswered.
"We don't know if a person filled a prescription, did they actually take it and what dose did they take," he said. "There's a lot of important information that's simply not available, despite the rigor with which these authors approached their analyses," Antman explained.
"In general, the more selective against cox-2 these drugs are, the greater the risk," Antman concluded. "We should stop there, because anything else -- regardless of what you read in the paper -- becomes extremely speculative."