Painkillers increase stroke risk

COMMONLY-USED painkillers can increase the risk of a stroke if taken in large doses, research has revealed.

Patients taking daily painkillers should seek advice Patients taking daily painkillers 'should seek advice'.

And patients with a high risk of heart disease who use large amounts of ibuprofen were warned last night to stop and seek medical advice.

Expert analysis of 31 clinical trials on more than 116,000 patients showed that heart patients using a high-dose painkiller every day for a year could triple their risk of a stroke.

More than nine million Britons take ibuprofen each day and 2.5 million suffer from heart disease.

Many more are at high risk because they are obese, smoke, have high blood pressure, raised cholesterol and diabetes. The review concluded that the pills are not safe for heart patients. While some increase the risk of a stroke, others could cause heart attacks.

Professor Peter Juni, from the University of Bern, in Switzerland, who led the study, said: “It is very important that people take these drugs at as low a dose as possible as occasionally as possible.”

When asked what older patients with a risk of heart disease who take large doses of painkillers each day should do, he said: “Stop immediately and see your doctor”.

But Prof Juni added that he believed there was still not enough data to prove that non-steroidal anti-inflammatory drugs, known as NSAIDs, and prescription arthritis drugs – Cox-2 inhibitors – are safe for heart patients even at low doses.

“We simply do not know for sure what happens at lower doses,” he said.

The study, published in the British Medical Journal online, is not the first to suggest a link between anti-inflammatory drugs and heart problems.

Boxes of ibuprofen sold over the counter warn patients not to take more than 1200 milligrams a day for this reason. And most doctors are now cautious of prescribing NSAIDs to patients with heart disease.

The latest research analysed patients who were mainly over the age of 65, already ill with conditions such as osteoarthritis and taking large doses of ibuprofen or other painkillers. This dosage would need to be prescribed by a doctor.

It found that over a year, those at risk of heart disease who took a dummy pill were three times less likely to have a stroke than those taking 2400 mg of ibuprofen.

This dose is normally given to patients suffering from chronic, long-term pain from conditions such as arthritis.

The study did not suggest any dangers for patients taking a lower dose of ibuprofen or other drugs.

It also revealed that a drug called lumiracoxib increased the risk of heart attacks.Another, diclofenac, almost tripled the risk of stroke.

Etoricoxib and diclofenac were also associated with around a four-fold increased risk of suffering death from cardiovascular causes.

Rofecoxib more than doubled the risk of heart attack, the researchers noted. This drug – brand name Vioxx – was withdrawn in 2004 when other studies found it raised the risk of heart attacks.

Patients were last night told not to panic because the overall risk of a stroke is still very low.

Even though ibuprofen may triple this risk, it is still a small chance.

Professor Peter Weissberg, medical director at the British Heart Foundation, said: “Some patients with debilitating joint pains may consider the small increased risk worthwhile when set against the improvement in their quality of life that these drugs bring.”

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