The headlines scream: NSAIDs linked to Cardiac Arrest! And if you’re like most of us who use the occasional over-the-counter ibuprofen (trade names Advil, Motrin and others) or have been prescribed anti-inflammatory medications like diclofenac (trade name Voltaren and others) it would be reasonable for you to be concerned. But as we have discovered in the past, the headlines don’t always tell you what you need to know.
The headlines are based on a nifty study. In Denmark they have a massive registry of everyone and so they were able to track down everyone who had a cardiac arrest in the country from 2001 to 2010, a total of 28,947 people. A cardiac arrest is when the heart suddenly stops beating and the person collapses. If you see it on television, they race to defibrillate the heart with a jolt of electricity. Out of all of the cardiac arrests recorded by the registry, 3,376 had used a nonsteroidal anti-inflammatory drug in the 30 days before the unfortunate event happened. Most commonly used were ibuprofen and diclofenac.
The authors reported that if you had a cardiac arrest and had used an anti-inflammatory in the preceding 30 days, the use of either ibuprofen or diclofenac did appear to increase the risk. If you look at the study it quickly becomes apparent that they were not talking about a 30 year old who sprained his shoulder and took some over-the-counter motrin for his pain relief for a couple of days. Most of these patients were elderly and had underlying risk factors for a heart attack.
So what's the real message that the hype may have hidden? If you are older or have a history of heart disease or have conditions like high blood pressure or diabetes that will increase your risk of a heart attack, don't take an anti-inflammatory medication even if it's over-the-counter without talking to your pharmacist or doctor.
Anti-inflammatory medications used properly really can make a huge difference for pain control. But they do have potential side effects ranging from stomach irritation and possibly increasing the risk of a stomach ulcer to salt and water retention, kidney problems and raising your blood pressure, so as with all medications, over-the-counter or not, the same rules apply:
Use them wisely; use them only when you need to; and, read the labels so you use them the way that they are supposed to be used.