Taking pain medicine can make heart disease worse

Common pain medications can increase the risk of a heart attack in people over 60 with a weak heart, according to a new study.

That risk is even higher for people who have had a heart attack. Even people who use pain medication for a short period of time can be dangerous, especially those taking blood pressure-lowering medications.

The pain medications mentioned in this study are called 'nonsteroidal anti-inflammatory drugs' (NSAIDs). Common NSAIDs include medications:

1. Indomethacin (brand name drugs like Indocin, Indocin SR).
2. Naproxen (brand name drugs like Aleve and Naprosyn).
3. Ibuprofen (brand name medicines like Advil and Motrin).

Non-steroidal anti-inflammatory drugs ( NSAID ) - Photo: fhcrc.org

The study, led by Dr. Consuelo Huerta, of the Spanish Center for Pharmaco-epidemiologic Research in Madrid, surveyed data on 228,660 patients collected in the UK. from 1997 to 2000.

Although NSAIDs increase the risk of heart failure patients, they generally do not pose a risk to most others, according to the study.

Dr. Huerta and colleagues wrote in the report about the study: 'The use of NSAIDs is only a small risk that causes patients to go to the hospital for the first time because of a heart attack. Where patients have been diagnosed with a heart attack, the use of NSAIDs can exacerbate their heart condition and make them hospitalized. '

The study was published on the website of 'Heart' special edition , published in London, England.

These new findings do not surprise heart experts, according to Dr. Andrew L. Smith, who specializes in heart disease at Emory University in Atlanta.

He said in an interview with WebMD: 'The data from this study is not surprising to those of us who often care for many patients who have had a heart attack. What NSAIDs can cause high blood pressure. But this is rarely recognized by people who provide primary care [family general practitioners]. This is a dilemma because many cardiovascular patients often suffer from arthritis and other painful conditions that require these drugs to relieve pain. '

Dr. Smith said that the problem is not that NSAIDs are direct toxins to the heart, but because their way of losing the effects of blood pressure lowering drugs. For patients whose lives depend on medications that help them reduce blood pressure, the effects may be severe and sudden.

Dr. Smith said: 'In our hospital, we are able to recognize the immediate effect when a severe heart attack patient takes NSAIDs. The day before diuretics [help lower their blood pressure] work. The next day, the stagnant water in the body caused them to go to the hospital. Severe consequences depend on their heart condition. '

Dr. Homeyar Dinshaw, a heart disease specialist with the Ochsner Clinic hospital system, told patients who need NSAIDs to follow up on signs that their bodies are stagnant.

He said: 'Recently, I began to tell patients that if they take NSAIDs, they need to monitor fluid retention, by examining their weight at the same time each morning. At other times, I told them to comment on the skin below the line. If you press your finger on the surface a little higher than your ankle and see a dent in the meat, it means your body holds the water. '

Dr. Smith advises people with heart disease if pain medication is needed, take acetaminophen - such as Tylenol - instead of taking NSAIDs