The news on non-steroidal anti-inflammatory drugs just keeps getting worse and worse. Just a month ago I posted about how this class of drugs was associated with an increased risk of heart problems. Now a Danish study has found that these drugs are associated with an increased risk of stroke.
This class of drugs known as NSAIDs are used mainly as pain killers. They are also used to effectively reduce fevers. They are available over the counter and are used by millions upon millions of Americans every day. This new
study finds that even short-term use of these drugs leads to an increased risk of having a stroke in the future. What’s even scarier is that they studied a healthy population.
In many instances these types of studies are done on people with already existing conditions that make it difficult to assess whether the increased risk is associated with a person’s previously existing condition or the medication. Not this time.
Over 500,000 healthy Danish people were included in this study. The authors used a prescription registry to track which of these people were prescribed an NSAID. About 45% of them took an NSAID from 1997-2005. They then used stroke data from further hospitalization and death registries and estimated the risk of fatal and nonfatal stroke associated with the use of NSAIDs.
Results showed that NSAID use was associated with an increased risk of stroke. This increased risk ranged from about 30% with ibuprofen (Advil) and naproxen (Aleve) to 86% with diclofenac (Voltaren). The data were controlled for age, gender, and socioeconomic status.
They noted that there was a dose dependent relationship as well. With doses over 200mg of ibuprofen the risk increased by a staggering 90%! This is quite problematic as the base dose for over the counter ibuprofen is 200mg. Millions of Americans take much more than that on a daily basis.
The authors of the study were not terribly surprised by the data considering the recent studies that have surfaced regarding the negative effects these medications seem to have on the cardiovascular system. They did say it is hard to make absolute conclusions because no randomized controlled studies exist to date. In light of this most recent evidence I doubt you will ever get an institutional review board to approve such a study because the risk seems to be too high.
The author also stated that in Denmark the availability of NSAIDs over the counter is relatively low compared to the United States. He stressed the need for closer monitoring of these drugs.
He also said, “If half the population takes these drugs, even on an occasional basis, then this could be responsible for a 50% to 100% increase in stroke risk. It is an enormous effect.”
In my opinion, we need to regulate these drugs as closely as possible. If one were to watch the evening news you would see these drugs being advertised as health food practically. It is studies like these that make it abundantly clear they are not without risk.
Options abound for people who take these on a regular basis for mild to moderate pain. Exercise and diet are a great start. Reducing the use of NSAIDs would likely have a very positive effect on the cost of health care in the U.S. We need all the help we can get in that department.