Common painkillers linked to cardiac arrest
15th March 2017 – Some painkillers perceived as harmless by the public may increase the risk of a potentially fatal cardiac arrest, a study has found.
The painkillers belong to a family of medicines called non-steroidal anti-inflammatory drugs ( NSAIDs), of which ibuprofen is probably the most widely recognised example.
Reducing pain and fever
NSAIDs are used to relieve pain, reduce inflammation and bring down a high temperature.
They are among the most commonly used medications in the world and some, including ibuprofen, are available over-the-counter.
Researchers led by a team from Copenhagen University Hospital Gentofte in Denmark set out to investigate whether there is a link between NSAIDs and cardiac arrest.
Using a database covering 10 years, they matched all people in the country who experienced a cardiac arrest while not in hospital with their use of NSAIDs in the preceding month. They identified 28,947 people who experienced cardiac arrest, of whom 3,376 had taken NSAIDs in the qualifying period.
Ibuprofen and diclofenac
Ibuprofen and diclofenac were the most commonly used NSAIDs, making up 51% and 21.8% of total NSAID use, respectively.
The scientists report that the use of any NSAID was associated with a 31% increased risk of cardiac arrest. Diclofenac was associated with a 50% higher risk and ibuprofen with a 31% increased risk.
Other medications in the group – naproxen, celecoxib and rofecoxib – were not associated with the occurrence of cardiac arrest, the scientists say. They add that this might be explained by their infrequent use in the sample.
The authors of the report, in the European Heart Journal - Cardiovascular Pharmacotherapy, say NSAIDs exert a number of changes to the body's cardiovascular system which could explain the link with cardiac arrest. These include causing platelets in the blood to clump together to form blood clots, constricting arteries, fluid retention and raising blood pressure.
Commenting by email, Dr Mike Knapton, associate medical director at the British Heart Foundation, says: "The most important point to take away from this study is to discuss all possible treatment options with your doctor, as well as the pros and cons of certain drugs, before you start taking any new medication. Although not all NSAIDs were found to be associated with increased risk of cardiac arrest, discussion with your doctor is imperative to make informed choice about the best treatment for you.
"For patients currently taking NSAIDS, including ibuprofen and diclofenac, the risks need to be reviewed and your specialist or GP will be able to advise on potential alternative treatments."