Daily ibuprofen may cause heart risks: U.S. study
Ibuprofen may raise the risk of heart attacks and other fatal and serious problems when elderly people take it daily for arthritis, U.S. researchers reported on Wednesday.
They said the popular over-the-counter pain reliever was the only drug in the class that includes aspirin and other analgesics to raise the risk of serious heart disease -- along with the now-withdrawn COX-2 inhibitor Vioxx.
Merck and Co. Inc pulled Vioxx, known generically as rofecoxib, off the market in 2004 because studies showed it raised the risk of heart attack and stroke.
The U.S. Food and Drug Administration now mandates a black-box warning on all COX-2 inhibitors and nonsteroidal anti-inflammatory drugs, or NSAIDs, which include aspirin, ibuprofen, naproxen and other over-the-counter pain relievers.
Dr. Daniel Solomon of Brigham and Women's Hospital in Boston and colleagues said their findings showed most of these drugs are safe.
"Our findings suggest that rofecoxib and ibuprofen are the only agents consistently associated with an increased risk for cardiovascular disease events among specific patient subgroups," Solomon said in a statement.
"The fact that we did not observe a similar concentration in risk among subgroups of patients using many of the other agents may be of even greater relevance. These results should bolster physicians' and patients' confidence," he added.
Writing in the journal Arthritis Care & Research, Solomon's team said they studied the medical records of patients from two databases of Medicare recipients enrolled in drug benefit programs between 1999 and 2004, prior to the restrictions on coxib use, for their study period.
They identified 76,000 new users of COX-2 inhibitors, prescription drugs that include Vioxx, Pfizer's Celebrex, and others. They also found 53,000 new users of NSAIDs and 46,000 patients taking drugs for thyroid problems or glaucoma who did not use painkillers.
The mean age of the patients, nearly all white women, was 80.
Vioxx users had the highest rates of heart attack, congestive heart failure and stroke, and naproxen users had the lowest, they found.
Among patients who had survived at least one heart attack, Vioxx users had 9.4 more serious heart events per 100 people per year, and ibuprofen users 11.4 more such events, compared to nonusers.
Solomon said the findings may apply only to elderly white women but they can help doctors and patients choose which drugs to take.