Some NSAIDs linked to heart attack, stroke
DEAR DOCTOR: Do NSAIDs really increase the risk of heart attacks, as I read in the news recently? I take aspirin or Tylenol whenever I get a headache, which is at least a few times each month.
DEAR READER: Yes, a body of research warns that NSAIDs are associated with an increased risk of heart attack and stroke.
Nonsteroidal anti-inflammatory drugs, or NSAIDs, are a widely used group of medications taken to reduce or relieve mild to moderate pain. Ibuprofen, which sells under brand names like Advil and Motrin, and naproxen, which appears under brand names like Aleve and Naprosyn, are among the more popular NSAIDs. Others include diclofenac and celecoxib, both of which require a prescription.
It’s estimated that up to 30 million people in the United States turn to NSAIDs each day to deal with aches and pains, cramps, fever and swelling. The drugs work by blocking the enzymes that produce compounds known as prostaglandins, which trigger the inflammatory response that your body uses to heal itself. That inflammatory response is what
causes the aches, pains, fever and swelling when we get hurt or fall ill.
However, NSAIDs also can act on platelet aggregation and cause blood clots, increase fluid retention, raise blood pressure and cause arteries to constrict. When this happens in the right combination and in the wrong person, it can lead to a heart attack or a stroke.
In 2005, the Food and Drug Administration issued a warning about the link between NSAIDs and stroke and heart attack. A decade later, working from the results of additional research, the FDA strengthened that warning. Since then, numerous studies have come to the same conclusion.
The aspirin you’re taking is an NSAID, but the good news is that it is exempt from the stroke/ heart attack warning. In fact, because aspirin inhibits the clotting of blood for periods of time ranging from four days to a week, it is commonly used to prevent heart attacks and strokes. Tylenol, the over-the-counter pain reliever you’re taking for headache pain, is not considered to be a NSAID.
Elizabeth Ko, M.D., is an internist and primary care physician at UCLA Health.