Pain Relievers May Help Bring On Heart Failure

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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 effects.

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 failure."

Vital Information:

  • 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 effects.
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