Two common painkillers, ibuprofen and diclofenac,
can slightly increase the risk of heart problems if
taken in high doses for a long time, data
suggests.
People with severe arthritis often take the drugs,
which also calm inflammation, to go about daily
life.
The researchers said some patients would deem the
risk acceptable, but they should be given the
choice.
A study, published in the Lancet , showed the
drugs posed even greater risks for smokers and the
overweight.
The risks have been reported before, but a team of
researchers at the University of Oxford analysed
the issue in unprecedented detail in order to help
patients make an informed choice.
The group investigated more than 353,000 patient
records from 639 separate clinical trials to assess
the impact of non-steroidal anti-inflammatory
drugs.
They looked at high-dose prescriptions levels,
rather than over-the-counter pain relief, of 150mg
diclofenac or 2,400mg ibuprofen each day.
They showed that for every 1,000 people taking
the drugs there would be three additional heart
attacks, four more cases of heart failure and one
death as well cases of stomach bleeding - every
year as a result of taking the drugs.
So the number of heart attacks would increase
from eight per 1,000 people per year normally, to 11
per 1,000 people per year with the drugs.
"Three per thousand per year sounds like it is
quite a low risk, but the judgement has to be made
by patients," said lead researcher Prof Colin
Baigent.
He added: "So if you're a patient and you go
and sit in front of your doctor and discuss it, you
are the one who should be making the judgement
about whether three per thousand per year is
worth it to allow you, potentially, to go about your
daily life."
He said this should not concern people taking a
short course of these drugs, for example for
headaches.
However, he did warn that those already at risk
of heart problems would be at even greater risk as
a result of the high-dose drugs.
High blood pressure, cholesterol and smoking all
increase the risk of heart problems.
Prof Baigent said: "The higher your risk of
heart disease, the higher your risk of a
complication. Roughly speaking, if you've got
double the risk of heart disease, then the risk of
having a heart attack is roughly doubled."
He said patients should consider ways to reduce
their risk, which could include statins for some
patients.
Alternative
A similar drug called rofecoxib (known as
Vioxx), was voluntarily taken off the market by
its manufacturer in 2004 after similar concerns
were raised.
There are more than 17 million prescriptions of
non-steroidal anti-inflammatory drugs in the UK
each year. Two thirds are either ibuprofen or
diclofenac.
A third drug, naproxen, had lower risks of heart
complications in the study and some doctors are
prescribing this to higher-risk patients.
The drug does a similar job to aspirin by stopping
the blood from clotting although this also
increases the odds of a stomach bleed.
Prof Alan Silman, medical director of Arthritis
Research UK, said the drugs were a "lifeline"
for millions of people with arthritis and were
"extremely effective in relieving pain".
He added: "However, because of their potential
side-effects, in particular the increased risk of
cardiovascular complications which has been known
for a number of years, there is an urgent need to
find alternatives that are as effective, but safer."
Prof Donald Singer, member of the British
Pharmacological Society and from the University
of Warwick, said: "The findings underscore a
key point for patients and prescribers - powerful
drugs may have serious harmful effects.
"It is therefore important for prescribers to take
into account these risks and ensure patients are
fully informed about the medicines they are
taking."



http://m.bbc.co.uk/news/health-22694858

Ah! Na wetin man go use for pains wey no go get side effect?
I just found that Diclofenac is good for back pains (òpá èyìn).

I think the study says it's prolonged use of such painkillers that leads problems