Weighing the Risks

Existing research points to increased risk of heart attack, stroke or death when taking painkillers used to treat inflammation, such as Celebrex and Advil.

Non-steroidal anti-inflammatory drugs (NSAIDs) are commonly used to treat pain and have been linked to cardiovascular events, especially in higher doses and when used for long periods of time, but uncertainty remains regarding the magnitude of these risks and how the risks might vary among different NSAIDs, according to Dr. Gregg Fonarow, American Heart Association spokesman and professor of cardiology at the University of California, Los Angeles, who was not involved in the study.

For a meta-analysis of existing research linking NSAIDs to cardiovascular events, a team led by Dr. Peter Juni from the Institute of Social and Preventive Medicine at the University of Bern reviewed 31 trials that included 116,429 patients. Some of the painkillers included in the analysis included: naproxen (Aleve®), ibuprofen (Advil®, Motrin®), diclofenac (Voltaren®, Cataflam®), celecoxib (Celebrex®), etoricoxib (Arcoxia®), rofecoxib (Viox®x), lumiracoxib (Prexige®) or placebo.

The number of cardiovascular events in patients taking these drugs was low, according to researchers with 554 heart attacks occurring in 29 trials and 377 strokes reported among 26 trials. In 28 of the trials, a total of 676 people died.

Patients taking rofecoxib (Vioxx®) and lumiracoxib (Prexige) were twice as likely to experience heart attack than those taking placebo, and those taking ibuprofen were three times as likely to have a stroke compared to controls.

Overall, naproxen (Aleve®) appeared to be the least harmful medication.