Common painkillers have more side effects than we think, including the risk of ulcers and increased blood pressure and should be used with great care in patients with heart disease, a new study has warned.
Nonsteroidal Anti-Inflammatory Drugs (NSAIDs) are used to treat a wide range of diseases, in particular disorders in the muscular and bone system, where the drug counteracts swelling, pain and limitations in movement associated with inflammation.
NSAIDs are not antibiotics and therefore do not help to fight infections caused by bacteria.
Many patients are prescribed NSAIDs for the treatment of painful conditions, fever and inflammation.
However, the treatment also comes with side effects, including the risk of ulcers and increased blood pressure.
This shows that arthritis medicine is particularly dangerous for heart patients, and also that older types of arthritis medicine, which have not previously been in focus, also appear to be dangerous for the heart, researchers said.
"It's been well-known for a number of years that newer types of NSAIDs - what are known as COX-2 inhibitors, increase the risk of heart attacks," said Morten Schmidt, from Aarhus University in Denmark.
"For this reason, a number of these newer types of NSAIDs have been taken off the market again," Schmidt said.
"We can now see that some of the older NSAID types, particularly Diclofenac, are also associated with an increased risk of heart attack and apparently to the same extent as several of the types that were taken off the market," he said.
"This is worrying, because these older types of medicine are frequently used throughout the western world and in many countries available without prescription," he said.
Each year, more than 15 per cent of the population in western countries are given a prescription for NSAIDs.
In the study, the researchers gathered all research on the use of NSAIDs in patients with heart disease.
The survey means that the European Society of Cardiology has now for the first time formulated a number of recommendations about what doctors should consider before prescribing painkillers to their patients.
"When doctors issue prescriptions for NSAIDs, they must in each individual case carry out a thorough assessment of the risk of heart complications and bleeding," said Christian Torp-Pedersen from Aalborg University in Denmark.
"NSAIDs should only be sold over the counter when it comes with an adequate warning about the associated cardiovascular risks," said Torp-Pedersen.
"In general, NSAIDs are not to be used in patients who have or are at high-risk of cardiovascular diseases," he said.
The study was published in the European Heart Journal.