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Congestive heart failure linked to NSAIDs

IHN logo Researchers at the University of Newcastle report that the use of NSAIDs (nonsteroidal anti-inflammatory drugs) such as aspirin, ibuprofen, indomethacin, naproxen, etc. is associated with a significantly increased risk of congestive heart failure. Heart failure is a common condition among the elderly. It is estimated that 500,000 Americans develop the disorder every year and that almost 2.5 million currently suffer from it. Congestive heart failure (CHF) is also common in Australia where more than 10 in every 1000 people over 65 years of age are admitted to hospital with CHF every year. The study involved 365 patients who were admitted to hospital with a primary diagnosis of CHF and 658 controls who were admitted for other reasons. The researchers discovered that the use of NSAIDs (other than low-dose aspirin) in the week prior to admission was associated with a doubling of the risk of CHF. Patients with a history of heart disease were 10 times more likely to develop CHF if they had used NSAIDs than if they had not. Compared with the study participants who did not have heart disease and did not use NSAIDs, the participants who had a history of heart disease and used NSAIDs had a 26 times greater risk of being admitted with CHF.

NSAIDs with a long plasma half-life were associated with a particularly high incidence of CHF. Patients with a history of heart disease who had used naproxen, piroxicam or tenoxicam were 24 times more likely to develop CHF than were heart patients who had not used any NSAIDs. The researchers caution heart patients against using the long-acting NSAIDs and conclude that 19 per cent of all patients admitted to Australian hospitals with CHF got there because of their use of NSAIDs. Translated to the situation in the United States, this means that almost 100,000 people develop CHF every year because of their use of NSAIDs. This number of "casualties" is similar to the number of people admitted to hospital with major gastrointestinal tract bleeding and ulcer perforation caused by the use of NSAIDs. NOTE: This study was funded in part by Pfizer Australia Pty Ltd, a major manufacturer of pharmaceuticals.
Page, John and Henry, David. Consumption of NSAIDs and the development of congestive heart failure in elderly patients. Archives of Internal Medicine, Vol. 160, March 27, 2000, pp. 777- 84

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