Cardiovascular Risks with Non-Steroidal Anti-Inflammatory Drugs
Author Information
Author(s): Patricia McGettigan, David Henry
Hypothesis
What are the cardiovascular risks associated with individual NSAIDs at typical doses in community settings?
Conclusion
Naproxen and low-dose ibuprofen are least likely to increase cardiovascular risk, while diclofenac elevates risk.
Supporting Evidence
- Thirty case-control studies included 184,946 cardiovascular events.
- 21 cohort studies described outcomes in over 2.7 million exposed individuals.
- The highest overall risks were seen with rofecoxib and diclofenac.
- Naproxen was risk-neutral at all doses.
- Risk estimates were constant with different background risks for cardiovascular disease.
Takeaway
Some pain relievers can hurt your heart more than others. Naproxen and low-dose ibuprofen are safer choices.
Methodology
Systematic review of community-based controlled observational studies analyzing cardiovascular risks of NSAIDs.
Potential Biases
Potential confounding by indication and unmeasured variables.
Limitations
The study relied on observational data, which can be subject to biases.
Participant Demographics
Included over 2.7 million individuals across various studies.
Statistical Information
P-Value
p<0.05
Confidence Interval
95% CI 1.33, 1.59 for rofecoxib; 95% CI 1.27, 1.55 for diclofenac; 95% CI 1.11, 1.25 for ibuprofen; 95% CI 1.02, 1.16 for naproxen.
Statistical Significance
p<0.05
Digital Object Identifier (DOI)
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