Common Painkiller, Diclofenac, Associated With a Higher Risk of Heart Problems

Popular NSAID pain reliever linked to serious heart health risk

The results that have been obtained are based on national registry data collected from 6.3 million adults in Denmark taken from 1996 to 2016.

Average age was 46-49 years among participants starting NSAIDs and 56 years among those starting paracetamol.

Diclofenac is the most commonly used non-steroidal anti-inflammatory drug (NSAID) in low, middle, and high income countries, and it is prescribed to millions of people in the United Kingdom every year.

So a research team, led by Morten Schmidt at Aarhus University Hospital in Denmark, examined the cardiovascular risks of starting diclofenac compared with no NSAIDS, starting other traditional NSAIDs and starting paracetamol. Diclofenac use overall was also associated with a higher risk of gastrointestinal bleeding compared to most other NSAIDs and acetaminophen, but its risk was similar to the NSAID naproxen (commonly sold as Aleve).

"In our study, we found that diclofenac initiators were at increased risk of major adverse cardiovascular events - both compared with no NSAID initiation, initiation of paracetamol as an analgesic alternative to NSAIDs, as well as initiation of other traditional NSAIDs", the authors wrote in the British Medical Journal.

However, he added that non-steroidal anti-inflammatories (NSAIDs) is still "worthwhile for some patients" - although he said patients should try other NSAIDs first before diclofenac.

One of the world's most-used painkillers, diclofenac, the active component in Difene, has been linked to an increased risk of heart attack and stroke in a major study published on Wednesday morning. Because it would likely be unethical (and costly) to conduct the sort of large-scale randomised trial that could definitively confirm these suspicions, though, the Danish researchers behind the new paper opted for an unique sort of study.

Specifically, the risk of such adverse cardiovascular events was 50 percent higher among those who started taking diclofenac, compared with those who did not take it.

The incidents included irregular heart beat or flutter, ischaemic stroke, heart failure and heart attack. The authors then compared the documented health issues that arose within 30 days in individuals given a course of diclofenac (1.3 million people) to those of 3.8 million people given ibuprofen, 291,490 given naproxen, 764,781 people given the non-NSAID pain reliever paracetamol, and 1.3 million people not prescribed any drug at all.

The cardiovascular threat also increased with the risk at baseline.

The study also relies on observational data, so it can't directly prove that diclofenac is causing problems. However, the study's sample size is larger than most previous analyzes of observational and randomized studies taken together and provides strong evidence to guide clinical decision making.

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