People using non-steroidal anti-inflammatory drugs (NSAIDs), which include over-the-counter analgesics such as ibuprofen or naproxen, have an increased risk of hospital admission due to heart failure Researchers from the Centro Espanol de Investigacion Farmacoepidemiologica in Madrid found that NSAIDs might worsen the conditions in patients with pre-existing heart failure, further triggering the need for hospital admission. To investigate, the researchers compared NSAID use among 1,396 individuals between 60 and 84 years of age who were hospitalised for non-fatal heart failure and a random sample of 5,000 subjects (controls). Fourteen percent of the heart failure patients were current NSAID users compared with 10 percent of the controls. NSAIDs were primarily used for osteoarthritis. The overall risk for hospitalization due to heart failure with the use of NSAID increased by 30 percent after accounting for major heart failure risk factors. The increased risk of heart failure hospitalization associated with individual NSAIDs ranged from 10 percent with diclofenac to more than threefold with indomethacin. The dose and duration of use of the drugs had no apparent effects. Heart failure hospitalization was also associated with known risk factors including high blood pressure, diabetes, kidney failure, other heart disease and anemia. Obesity, smoking, alcohol use, and recent hospitalizations and specialists' visits -- two indicators of other illness - were also associated with an increased risk of hospitalization. However, a prior diagnosis of heart failure was the main risk factor triggering a first hospitalization for heart failure, increasing the risk by more than sevenfold. The findings suggest that NSAIDs trigger the risk of hospitalization for heart failure in patients without a history of heart failure.
Heart,
May 2006