UF studies look at relationship between pain relievers and heart attack


Published: Tuesday, July 15, 2014 at 3:58 p.m.
Last Modified: Tuesday, July 15, 2014 at 3:58 p.m.

A common, over-the-counter pain medication increases the risk of heart attack and stroke for some women, University of Florida researchers say.

A study into the cardiovascular effects of nonsteroidal, anti-inflammatory drugs — also known as NSAIDs — concluded that regular use of naproxen, an active ingredient in multiple prescription drugs and the over-the-counter drug Aleve, increased the risk of heart attack, stroke and death in postmenopausal women by 10 percent.

“It is counter to the perception of the medical community because there was a thought that when it came to NSAIDs, naproxen was a safer agent,” said Dr. Anthony Bavry, a UF cardiologist and the study’s lead author. “We didn’t find that.”

For the study, taking naproxen at least twice a week for the prior two weeks was deemed regular usage.

UF and Harvard University researchers conducted the study as part of the Women’s Health Initiative, a program launched with federal funding in the 1990s to focus on health issues in postmenopausal women.

The Women’s Health Initiative included health and medical data from more than 160,000 women. Of those, 53,142 women regularly used NSAIDs for pain issues such as arthritis.

Dr. Marian Limacher, UF’s lead Women’s Health Initiative researcher since 1994, said NSAIDs work by inhibiting two enzymes causing inflammation: cox-1 and cox-2.

Naproxen inhibits cox-2 more than cox-1, and that, she said, leads to the higher risk of heart attacks since cox-2 helps prevent blood clots.

Bavry said the study looked separately at NSAIDs that focused on cox-1 and those that primarily inhibited cox-2.

In the case of ibuprofen, an NSAID that primarily works on cox-1, the study found no link to heart attack, cardiovascular problems or stroke.

In an interview with U.S. News & World Report, American Heart Association President Dr. Elliott Antman was skeptical of some of the study’s conclusions.

“The totality of the evidence still leaves us comfortable recommending naproxen as a medication that can be used for a short period at a lower dose for people with risk of heart disease,” Antman said in the interview.

Asked about those comments, Bavry said the conclusions had generated some controversy in the medical community because it went against the long-held belief that naproxen was safer among NSAIDs. But Bavry said researchers in this study felt there was no concrete data to back up that belief.

He said the takeaway is that a postmenopausal woman should take notice and consult with her doctor before regularly using any medication with naproxen.

In a separate, recent UF study related to the relationship between pain medications and heart attack risk, researchers found that only 40 percent of patients at high risk of cardiovascular disease reported receiving a recommendation from a doctor to start an aspirin treatment that could reduce their risk.

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