Do you think twice before popping in a painkiller analgesic in your mouth. If no, read this!
A recent meta-analysis was done to study the effects of analgesics like ibuprofen, diclofenac and coxibs on heart risks, stroke risk, and gastric bleeding risks.
The meta-analysis included 280 randomized trials of analgesics (non-steroidal, NSAID) versus placebo with 124 513 participants, 68 342 person-years. It also included 474 trials of one NSAID versus another NSAID 229 296 participants, 165 456 person-years. It was published recently in the Lancet.
The main outcomes were major vascular events like heart attacks, stroke, or vascular death and gastrointestinal complications like perforation, obstruction, or bleed.
Major vascular events like heart attacks and strokes were increased by about a third by all the analgesics like coxib, diclofenac. Ibuprofen also significantly increased major coronary events. Compared with placebo, of 1000 patients allocated to a coxib or diclofenac for a year, three more had major vascular events, one of which was fatal.
Naproxen did not significantly increase major vascular events.
Heart failure risk was roughly doubled by all NSAIDs.
All NSAID regimens increased upper gastrointestinal complications like bleeding and perforation.
The vascular risks of high-dose diclofenac, and possibly ibuprofen, are comparable to coxibs, whereas high-dose naproxen is associated with less vascular risk than other NSAIDs.
Although NSAIDs increase vascular and gastrointestinal risks, the size of these risks can be predicted, which could help guide clinical decision making
In view of the above findings it would be advisable not to pop in a pain killer for mild aches and pains. Patients who need pain killers for chronic pain should take them strictly under medical supervision.