Published: Sun, September 09, 2018
Medicine | By Tracy Klein

Common painkiller linked to higher risk of heart attack and stroke

Common painkiller linked to higher risk of heart attack and stroke

According to Daily Mail, many parts of the world - including the United Kingdom - have banned diclofenac as an over-the-counter medication because of its adverse effects on the cardiovascular system.

Common painkillers may hide major risks, says a new study.

Diclofenac is a component frequently found in painkillers used to treat back pain, sciatica and arthritis.

But the painkiller is still prescribed to five million Brits every year.

However, due to ethical concerns, these risks can not be evaluated in clinical trials.

However, he added that non-steroidal anti-inflammatories (NSAIDs) is still "worthwhile for some patients" - although he said patients should try other NSAIDs first before diclofenac. Diclofenac use overall was also associated with a higher risk of gastrointestinal bleeding compared to most other NSAIDs and acetaminophen, but its risk was similar to the NSAID naproxen (commonly sold as Aleve).

At the time, six million prescriptions were written for diclofenac, then also available over the counter.

All subjects who were not taking diclofenac were matched by propensity score to diclofenac users, meaning that the groups were created to mitigate influences from factors like age and pre-existing diseases.

After taking account of potentially influential factors, starting diclofenac during the study period (1996-2016) was associated with an increased rate of major adverse cardiovascular events within 30 days compared with starting other traditional NSAIDs (ibuprofen or naproxen) or starting paracetamol. The increased risks applied to men and women of all ages and also at low doses of diclofenac.

The researchers advised that diclofenac should come with front of package warnings about its risks after the study found that patients who started diclofenac were at a 50% increased risk of cardiovascular events - such as heart failure, heart attack or atrial fibrillation - in the 30 days after starting the drug compared with those not taking the drug. In other words, the higher the risk of heart problems when the patients started taking the drug, the higher the risk of actually developing heart problems over the course of the treatment. The researchers took participants between the ages of 46 to 56 and placed them in three different groups based on whether they were a low, medium, or high baseline for cardiovascular problems.

While the researchers did acknowledge this was an observational study, they also noted the sample sizes they used were larger than what has been used with previous research on the same subject. "Considering its cardiovascular and gastrointestinal risks, however, there is little justification to initiate diclofenac treatment before other traditional NSAIDs", the study concluded.

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