Postmenopausal women taking NSAIDs at risk of cardiovascular events

Regular use of nonsteroidal anti-inflammatory drugs (NSAIDS) increases the risk of stroke, heart attack and death in postmenopausal women, according to a study just published in the journal Circulation: Cardiovascular Quality and Outcomes.

Whilst doctors already know that (NSAIDs) that target and inhibit the COX-2 enzyme can raise a person's heart attack risk, this new study found the same sort of heart risks accompany NSAIDs that don't specifically target cox-2, but still inhibit the enzyme to some degree.

UF cardiologist Anthony Bavry, M.D., the study's lead author, said: "Many people think that naproxen is the safer NSAID," he said. "This study is counter to our previous understanding of these agents, and signals to me that we need to further research these agents for safely treating chronic pain syndromes in women."

Bavry, in collaboration with researchers from Harvard and other universities, combed through data from more than 160,000 postmenopausal women who were surveyed as part of the Women's Health Initiative - a 15-year research study funded by the National Institutes of Health. Of these women, 53,142 regularly used NSAIDs. Even after controlling for obesity, hypertension, diabetes, use of aspirin and other health factors, the researchers found the increased risk for heart attack, stroke or death among the women who used certain types of NSAIDs.

One of the study's co-authors, Marian Limacher, M.D., has been the UF principal investigator for the Women's Health Initiative since 1994. About this study, Limacher noted that this was the first study of its size to examine the effects of regular NSAID use on women.

"When we study agents such as aspirin, we have found differential effects in men and women," Limacher said. "Men had reduction in heart attack, and older women had a reduction in stroke but not heart attack, which is part of the reason those of us studying women feel we really need to have adequate information on commonly used drugs for both men and women."

The study's main finding confirmed that the regular use of any NSAID was associated with harm such as digestive bleeding. Although it found for the first time that the risk of heart attack, stroke or death was associated with the use of naproxen, the study found no cardiovascular or stroke harm associated with ibuprofen.


July 2014, Circulation: Cardiovascular Quality and Outcomes