Popular NSAID Pain Relievers
Increase Risk of Heart Attack and Stroke
NSAID (Nonsteroidal anti-inflammatory drugs)
pain relievers may increase their risk of heart attack and stroke.
People commonly use NSAIDs, especially OTC formulations, to reduce fever and relieve pain caused by conditions such as arthritis, headache, toothache, back pain, muscle pain, menstrual cramps or minor injury.
Previous studies linked NSAIDs and cardiovascular risks in persons with other high risk factors or established heart disease, however this study is the first to measure the increased cardiovascular risk caused by NSAIDs in healthy people.
“We conducted this study to answer whether any specific NSAID carried a risk of cardiovascular adverse events among healthy individuals and to explore if there were safer alternatives within the group of NSAIDs,” study authors said.
Researchers in Denmark studied 1,028,437 healthy Danish individuals with an average age of 39 from January 1, 1997 to December 31, 2005 for increased cardiovascular morbidity and mortality with the use of rofecoxib (Vioxx), diclofenac, celecoxib, naproxen and ibuprofen.
Rofecoxib, marketed as the brand name Vioxx, is no longer available in the United States. Merck voluntarily withdrew the drug from the market in 2004 after studies showed an increased risk of heart attack and stroke. Vioxx was widely used in the U.S. before its withdrawal, generating $2.5 billion in sales revenue in 2003.
Diclofenac, marketed as brand names Cambia, Cataflam, Voltaren, Voltaren-XR and Zipsor, and Celecoxib marketed as Celebrex are only available by prescription in the U.S., while consumers can purchase ibuprofen over-the-counter (OTC) as brand names such as Advil, Motrin, Midol and Nuprin. Naproxen is available by prescription, but consumers can also purchase naproxen (Aleve) over-the-counter.
According to Healthday News, compared to people who took no NSAIDs, researchers of the study found that patients taking diclofenac had a 91% higher risk of death from heart attack and stroke, much higher than the 66% increased risk for those taking rofecoxib (Vioxx). People taking the largest doses of diclofenac saw risk of heart attack doubled and for those taking the largest doses of rofecoxib (Vioxx) risk tripled.
Perhaps the most relevant study finding for U.S consumers self-medicating with OTC ibuprofen products is that ibuprofen showed a 29% higher risk of stroke.
Researchers found no increased risk of heart attack or stroke with use of naproxen. Their analyses of celecoxib were not conclusive.
“Because treatment with NSAIDs is so widely distributed in the general population, it is also of great importance that a safe alternative is found when NSAID treatment cannot be avoided. The safety of naproxen has been much debated, but it is widely accepted that naproxen is probably the NSAID with the safest cardiovascular risk profile, and our results support this assumption,” the researchers said. “Our results suggest that naproxen could be a safer alternative when NSAID treatment is required.”
The study appears in the June 8, 2010 issue of Circulation: Cardiovascular Quality and Outcomes, a Journal of the American Heart Association.
The U.S. Food and Drug Administration (FDA) requires drug labels for NSAIDs to warn of increased risk of heart attack or stroke associated with long-term continuous use of the drug. The Denmark study population had a median exposure time to NSAIDs of 14 days, indicating short-time exposure in most individuals.
Retrieved November 10, 2010 from http://newyorkcity.injuryboard.com/fda-and-prescription-drugs/popular-nsaid-pain-relievers-increase-risk-of-heart-attack-and-stroke.aspx?googleid=282136
Wellspring Health Center offers a wholistic integrated approach for acute and chronic pain.
Our professional team of physical therapists provide hands on therapies including joint mobilization, myofascial release, deep tissue massage, laser therapy, neuromuscular re-education, and Pilates and yoga-based therapy, to not only relieve pain but rehabilitate imbalances in the nerves, muscles and joints.
If pain is preventing you from living life to the fullest, come and see us.
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Some of the side effects and health risks associated with taking nonsteroidal anti-inflammatories (NSAIDs) include stomach bleeding, ulcers, nausea, rash, headaches, dizziness, liver and/or kidney damage, and according to a recent Denmark study, NSAID use can increase the risk for heart attack and stroke (see article above). it is important to know about safer alternatives for reducing inflammation and pain. Natural products also support, rather than interrupt, the healing process. There are several choices when it comes to natural anti-inflammatory products. Keep in mind that not everyone responds the same. As long as there is no medical reason to not use a natural product, give it time to take effect. If you don't see results in a reasonable period of time, try another product.
Wobenzym is a unique systemic enzyme formulation originating in Germany. Systemic enzymes have been studied since the 1930’s. When taken on an empty stomach apart from meals they act as systemic enzymes, which have been shown to support immune function, support blood flow and circulation, healthy joint function and reduce soreness after exercise.(1) These benefits come from modulating the body’s inflammation process. In Jonny Bowden’s book, The Most Effective Natural Cures on Earth, he includes Wobenzym N under the heading “The Athlete’s Secret Weapon.” In the book, Dr. Bowden quotes Dr. Gary Gordon, “Wobenzym N gives you the same effects as aspirin, ibuprofen, and NSAIDs without any of the side effects.”(2) There is a vast amount of research available regarding systemic enzymes and the large number of health benefits associated with them, the following site contains many of those studies: http://www.systemicenzymesupport.org.
Wobenzym N can be found at local nutritional stores. The recommended dosage is 3 tablets twice per day on an empty stomach (at least 45 minutes prior to meals). If you are pregnant or breastfeeding, suffering from bleeding disorders or liver damage, or if you are taking anticoagulant drugs (such as warfarin), consult a healthcare professional before using this product. It can take two weeks of regular use to see a difference in symptoms.
One of the most cost effective ways to reduce pain and inflammation is to apply a cold pack. Cold packs are not just for acute injuries. For best results apply a cold pack, protecting the skin with a layer of towel, to the painful area for 20 minutes. Wait an hour before re-applying. The goal is to cool down the area, not numb it. This reduces inflammation naturally and flushes inflammatory chemicals out of the area. Cold packs are effective for acute and chronic pain as well as headaches.
Arnica gel is rubbed on the painful area two to three times per day. It can be used on strains, sprains and other bumps and bruises. Arnica, also known as Arnica montana, has been used for over 400 years. It is a perennial plant, whose flower heads are used to create ointments and creams. According to research described in a New York Times article, arnica gel was shown to work as well as daily ibuprofen for patients with arthritis.(3) For acute injuries, it’s best to use the gel immediately after the injury takes place. You can find it as a cream or gel at many natural health stores.
With the vast number of health benefits associated with high-quality fish oil, this isn’t a supplement that should be used only for overcoming pain or injuries. However, during times of increased inflammation, it may be beneficial to increase the amounts taken on a daily basis. EPA and DHA are omega-3 fatty acids that help to reduce inflammation levels in the body. From a dietary standpoint, it’s also important to limit the intake of omega-6 fatty acids found in conventionally raised higher fat meats, and many processed foods. Fish oil helps to increase the ratio of omega-3 intake compared to omega-6, which has been shown to reduce inflammatory levels in the body. Follow the dosage directions on the bottle.
Glucosamine & Chondroitin
Of all the dietary supplements targeted toward injury and recovery, glucosamine and chondroitin may be the most well-known. Many studies have been done on them. Although not every study has shown these supplements provide significant benefit, many have. Studies show that an effective dose should be 1500 mg of glucosamine sulfate and 1200 mg of chondroitin sulfate. Long-term use of 1500 mg a day of glucosamine was shown in research to reduce pain from osteoarthritis and stop the joint space narrowing.(4) A study completed in China showed 1500 mg of glucosamine was more effective at reducing pain from osteoarthritis in the knee than ibuprofen, as well as providing better mobility and less swelling. In the study, the glucosamine group also had less adverse side effects.(5) Combining glucosamine with chondroitin appears to be more beneficial.(6) It can take 45-60 days of regular use for people to notice a difference with these supplements.
1. Wald M, Honzikova M, Lysikova M. Systemic Enzyme Support – An Overview. Charles University, Prague. August, 2008. http://www.systemicenzymesupport.org/articles/wald.html
2. Jonny Bowden. The Most Effective Natural Cures on Earth. 2008. Fair Winds Press. Beverly, Massachusetts.
3. Anahad O’Connor. The Alternative Medicine Cabinet: Arnica for Pain Relief. <leo_highlight id="leoHighlights_Underline_0" style="border-bottom: 2px solid rgb(255, 255, 150); background-color: transparent; background-image: none; background-repeat: repeat; background-attachment: scroll; background-position: 0% 50%; -moz-background-size: auto auto; cursor: pointer; display: inline; -moz-background-clip: -moz-initial; -moz-background-origin: -moz-initial; -moz-background-inline-policy: -moz-initial;">The New York Times “Well” section. Sept 17, 2009
4. Pavelka K, Gatterova J, Olejarova M, Machacek S, Giacovellis G, Rovati LC. Glucosamine Sulfate Use and Delay of Progression of Knee Osteoarthritis - a 3-year, Randomized, Placebo-controlled, Double-blind Study. Arch Int Med. 2002;162(18):2113-23
5. Qiu GX, Gao SN, Giacovelli G, Rovati L, Setnikar I. Efficacy and Safety of Glucosamine Sulfate Versus Ibuprofen in Patients with Knee Osteoarthritis. Arzneimittel-Forschung. 1998;48(5):469-74
6. Bruyere O, Reginster JY. Glucosamine and chondroitin sulfate as therapeutic agents for knee and hip osteoarthritis. Drugs Aging. 2007;24(7):573-80
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