June 10th, 2010
09:06 AM ET

Pain relievers connected to heart deaths

By Elizabeth Landau
CNN.com Health Writer/Producer

Common pain medications are associated with higher risks of heart-related death in healthy people, a Danish study finds.

The research, published in the journal Circulation: Cardiovascular Quality and Outcomes, a journal of the American Heart Association, is the first to report on specific cardiovascular risks among healthy people.

Study authors looked at the use of nonsteroidal anti-inflammatory drugs (NSAIDs) in Denmark, based on records of more than 1 million healthy people over age 10 from 1997 to 2005. About 45 percent of people in the study took NSAIDs at least once over that time period, and those who did usually took the drug in low doses for about two weeks.

They found that ibuprofen - the main ingredient in Advil and Motrin - was associated with a 29 percent greater risk of fatal or nonfatal stroke, compared with people who did not take a prescription NSAID.

Diclofenac, marketed under various brand names including Voltaren and Cataflam, was linked to a 91 percent heightened risk of cardiovascular death. In the United States it is available by prescription; other countries sell it over the counter.

Rofecoxib, which was once sold in the United States as the controversy-mired Vioxx, was associated with a 66 percent greater risk of cardiovascular death in this study. Merck & Co. voluntarily recalled Vioxx in 2004 because of cardiovascular safety concerns, and has not reintroduced it.

Researchers found a two-fold higher risk of heart attack among people taking the highest-level doses of diclofenac and a three-fold risk with the highest does of rofecoxib.

Naproxen, on the other hand, was not associated with heart problem risks in this study. This drug is commonly marketed in the United States as Aleve. Researchers could not conclude anything about the risks of celecoxib, sold as Celebrex in the United States.

Pfizer Inc., maker of Advil and Celebrex, said in a statement that Advil is safe and effective when used according to the label instructions on the package, and the FDA has stated that the benefits of Celebrex outweigh the potential risks in properly selected and informed patients, Pfizer's statement said. McNeil Consumer Healthcare, maker of Motrin, echoed that "When used as directed, ibuprofen is safe and effective." Novartis, maker of Cataflam, said in a statement that the company is aware of the study, and that it "does not change the favorable benefit to risk assessment for diclofenac when used as directed."

"All prescription NSAIDs carry the same cardiovascular warning and may cause an increased risk of serious cardiovascular thrombotic events, myocardial infarction, and stroke, which can be fatal," Pfizer's statement noted.

The Danish study has implications for the U.S. population also, researchers said. The American Heart Association advised in 2007 that NSAIDs, except aspirin, for chronic pain upped the risks for heart attack and stroke, which is consistent with these findings.

Talk to your doctor if you have concerns about the medication you are taking.

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soundoff (71 Responses)
  1. Aspirin user

    What about plain old aspirin ? If it were discovered today, it would be considered a "wonder drug" – good for all sorts of inflammations, works for many fevers, generic headache relief, blood thinner... the list keeps getting longer. It doesn't kill your liver, so it's better than acetominophen (Tylenol), and has no reported links to heart death, all all these more "modern" pill seem to have. It's just that the patent on it expired A CENTURY AGO. So, the drug companies can't make a fortune off of it.

    Please, folks, use some common sense. For most of the things we're using a $20 pill to fix, the plain old 20 cent one will do fine – or even better.

    June 10, 2010 at 18:07 | Report abuse | Reply
  2. Jessica

    To Maria,
    Out of your 14 claims, I've read, and can cite (google is an amazing thing), roughly 12 contradictory studies with completely opposite conclusions. Also, your "facts" have the fingerprints of notoriously famous studies debunked YEARS AGO for bogus methods. Way to go. Its scary when you're loosing ground on something that SCARES you, huh?

    June 10, 2010 at 18:23 | Report abuse | Reply
  3. C A

    I've been taking 400 to 600 mg of naproxen daily for close to a year and a half due to serious arthritis in my knees, spine and shoulders. Joint replacement is unavoidable (for the knees, anyway), but my doctor says he doesn't want to do this just yet (he says he's not thrilled about doing this for someone under 45 years old).

    I've tried all of the OTC drugs listed here, and found Aleve the only think that works without any side effects. Acetaminophen does nothing; Advil and Motrin leave me with a headache; and aspirin caused my grandfather and mother to be hospitalized, for over a week each with ruptured ulcers, when they were prescribed aspirin as a "preventative" measure to guard against a stroke. I don't even want to give it a try!

    I won't do the prescription drugs, because I've seen first hand where the potential for addiction can lead. I did take hydrocodone for three days when I had my last knee surgery and HATED the way I felt (cloudy thinking and the constant desire to throw up), and that was with a 5 mg dose. For what it's worth: NSAIDS, MSM/glucosamine/chondroitin supplements, ice packs, and yoga is what allows me to live with a crumbling body and still function normally. And all liver/kidney tests are normal, and my bp is 120/55.

    June 10, 2010 at 18:52 | Report abuse | Reply
  4. Lauren

    its awesome how you just put on the news FOR 15 SECONDS about how Advil has given 29 percent of its users fatal and nonfatal strokes. what i dont understand is that you can take your time with putting up that but what about the people who are suffering from pain killer addiction (oxycotin, roxicotin, oxycodone) and i never see anything on it. it was shown in massachusetts where i am originally from THAT about 31,000 have been wounded and/or killed in iraq BUT the total number of deaths from pain killers is about 300,000 people in the last 3 years. this "war" we have goin on overseas is something we shouldnt be fighting. what we should be fighting is THE WAR ON DRUGS. think about it

    June 11, 2010 at 10:21 | Report abuse | Reply
  5. Bev

    C A Your doctor is not the one suffering the pain. Go for the knee replacement, the probable reason why your doctor is putting it off is, you will need another replacement in the future. Replacement knees typically only last 15 to 20 years. I was in the same situation, I had the total knee replaced and have no regrets to being pain free, without any medication.

    June 11, 2010 at 11:19 | Report abuse | Reply
  6. chuck

    Hello Aspirin user.

    I agree, aspirin is a wonder drug for 'short term' use. For people with ongoing, chronic pain and knowing how aspirin causes stomach ulcers, many choose another option.
    BUT... i still feel like I'm between a rock and a hard place on this issue.

    June 11, 2010 at 13:06 | Report abuse | Reply
  7. Canoli from Philly

    I hate when drug companies make any assertions when it is inherently bias no matter what they say. Either they try to bash one pill to sell their own or promote their own whithout disclosing conflict of interest. The best worst part is that the media such as this web site is so complicit and runs along like sheeps in a herd. Shame what this society has come down to when it comes to having a real intellectual conversation.

    June 11, 2010 at 16:11 | Report abuse | Reply
  8. elle

    I agree with dc_doc that a small amount of opiod medication is more effective and safer by a dimension for chronic pain than those risky NSAIDs. If not for the stigma and scare tactics, many more people would be in better health with better pain control. As with any medication, a patient must work closely and honestly with their physicians and deal with any side effects such as potential addiction, but for heaven's sake! These opiods are nowhere near as dangerous as the chemicals in NSAIDs. Opium grows naturally and has been used since the stone age for pain relief. Even by animals who know a good thing. Coca leaves too.

    Who suddenly decided that opioids were evil and ruined lives? It's high drama, anachronistic laws and paranoia that deprive pain sufferers of an excellent remedy and drive them to "approved" meds which we are now finding deleterious to their bodies.

    Let's be adults about this. We should remove the nasty (and not really effective) acetominophen from the hydrocodone products like vicodin (an approach which is now legally underway), and you have hydrocodone, a superb pain reliever, superior to codeine and with far fewer side effects. And it will not destroy your heart, your liver, your kidneys or your esophageal/stomach lining. Since most chronic pain sufferers are older people, what is the "danger to society?"

    We must educate young people on all medical issues and keep any and all medications safely locked away, as you would alcohol and benzodiazepines and anything that they don't need. The best protection for the young is self-esteem and respect for their bodies and their future potential. We will always have issues with youth experimenting, but why let generations of elderly and chronically suffering people harm themselves trying to find pain relief with these dangerous NSAIDs?

    June 13, 2010 at 15:44 | Report abuse | Reply
  9. Beth

    Maria.. in your post, when you say "marijuana," I think you mean "alcohol." Read up before you post to propagate hundred year-old critiques on a natural herb that you've been brainwashed into believing is of the devil.. k?

    Should have read..
    "What about the person drunk on alcohol who drives or operates some type of machinery and causes a major fatal accident? Not only that but with regular or frequent use, it does change brain chemistry causing problems with impulse control, distortion of perception, loss of learning ability/dementia, impaired coordination. It also can cause personality disorders or psychological problems such as anxiety, depression, even schizophrenia. Alcohol causes all the same pulmonary problems that cigarette smoking does such as emphysema, cirrhosis and heart disease. Alcohol is addicting unlike NSAIDs which are not addicting. It is more difficult to stop alcohol use than NSAIDs due to withdrawal symptoms"

    Who's lobbying to limit alcohol usage? Pass me a dutchie over a shot any day, please and thank you.

    June 13, 2010 at 18:55 | Report abuse | Reply
  10. Mila Jovovich

    it has been proven that alcohol is addictive and we must be careful with the reactions that cause us, but there are many ways that these reactions are avoided because, as stated in findrxonline many people mix this liquid with medicines like hydrocodone, vicodin , norco, which are anxiolytic and result in dangerous side effects to health care.

    October 27, 2010 at 13:37 | Report abuse | Reply
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    I am just curious of the MS symptoms. Isn't it that twitching face is a sign of it? I know for sure that nervous system disorders can lead to twitching and those nasty burning sensations on the skin but how much percentage if probability that twitching actually causes MS?


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