Routine NSAID use in females ups cardiovascular risks

Risk up with regular NSAID use, selective cox-2 inhibitor use, agents with cox-2>cox-1 inhibition.

Routine NSAID use in women increases cardiovascular risks
Routine NSAID use in women increases cardiovascular risks

HealthDay News -- Regular nonsteroidal anti-inflammatory drug (NSAID) use is associated with increased risk of cardiovascular events in postmenopausal women, according to a study published in Circulation: Cardiovascular Quality and Outcomes.

“Conclusive data about cardiovascular toxicity of nonsteroidal anti-inflammatory drugs are sparse,” wrote Anthony A. Bavry, MD, MPH, of the North Florida/South Georgia Veterans Health System Gainesville, and colleagues.

To assess the correlation between NSAID use and total cardiovascular disease (defined as cardiovascular death, nonfatal myocardial infarction, or nonfatal stroke), the researchers followed 160,801 postmenopausal female patients for a mean of 11.2 years.

More than 53,000 study participants reported regular NSAID use at some point in time, reported the investigators. Compared with nonuse, regular NSAID use correlated with an increased risk of cardiovascular events (hazard ratio, 1.10; P< 0.001). A modestly increased risk of cardiovascular events was seen with selective cyclooxygenase (cox)-2 inhibitors (HR, 1.13; P = 0.004; HR for celecoxib only, 1.13; P=0.031); the association did not persist among aspirin users. 

Agents with cox-2>cox-1 inhibition correlated with increased risk (HR, 1.17; P<0.001; HR for naproxen only, 1.22; P<0.001); the correlation persisted among concomitant aspirin users. Agents with cox-1>cox-2 inhibition were not associated with increased risk (HR, 1.01; P=0.884; HR for ibuprofen only, 1.00; P=0.996).

"Regular use of selective cox-2 inhibitors and nonselective NSAIDs with cox-2>cox-1 inhibition showed a modestly increased hazard for cardiovascular events," concluded the inspectors.

References

  1. Bavry A et al. Circulation: Cardiovascular Quality and Outcomes. 2014; doi: 10.1161/​CIRCOUTCOMES.113.000800
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