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09 September 2018, 04:57 | Melissa Porter
Diclofenac could increase heart failure
To conduct this study, the researchers utilized the national registry data containing details on the 6.3 million adults residing in Denmark. The average age was 46-49 years among NSAID initiators, and 56 years among those who started taking paracetamol.
Diclofenac is a component frequently found in painkillers used to treat back pain, sciatica and arthritis.
Researchers from Aarhus University Hospital in Denmark, who recently published a study British Medical Journal on the relationship between heart health and diclofenac, believe the drug should be globally banned as an over-the-counter medication. Diclofenac use overall was also associated with a higher risk of gastrointestinal bleeding compared to most other NSAIDs and acetaminophen, but its risk was similar to the NSAID naproxen (commonly sold as Aleve).
Diclofenac, a widely used global drug with anti-inflammatory and analgesic properties, is associated with an increased risk of heart attack, stroke and other serious cardiovascular problems, so its use should be done with moderation rather than for a long time. According to Daily Mail, many parts of the world - including the United Kingdom - have banned diclofenac as an over-the-counter medication because of its adverse effects on the cardiovascular system. During the follow-up period, between 1996-2016, the scientists eliminated other risk factors for cardiovascular diseases in the subjects who participated in the study.
"While NSAID use previously was considered risk-neutral in short treatment periods and low doses, the risks were apparent even within 30 days and also for low doses of diclofenac".
For those at moderate risk at the start, they found 7 extra cardiovascular events with diclofenac compared with ibuprofen or naproxen; 8 extra events compared with paracetamol; and 14 extra events compared with no NSAIDs.
Unfortunately, besides heart attacks, the study links diclofenac to cardiovascular disease which includes arrhythmic heartbeats, ischemic stroke, and heart failure.
The results also suggested that although the absolute risks associated with diclofenac use were highest in individuals who already demonstrated high baseline cardiovascular risk, the relative risk was actually highest in people with the lowest baseline risk.
However, they add: "This is an observational study, so no firm conclusions can be drawn about cause and effect".
Dr Schmidt said: "Treatment of pain and inflammation with NSAIDs may be worthwhile for some patients to improve quality of life despite potential side effects".
However, the study's sample size is larger than most previous analyses of observational and randomised studies taken together and provides strong evidence to guide clinical decision making.
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