Common pain killers such as ibuprofen and naproxen found to raise the risk of a heart attack within a week of use.
There is no evidence to support the claim that ibuprofen and naproxen raise the risk of heart attacks at any time.
Very recently the media warned people to avoid taking pain killers such as ibuprofen and naproxen to prevent the risk of heart attacks. The warning came following the publication of the results of a study in the British Medical Journal last month (1). The scientific community does not agree with popular press on the interpretation of the results of this study.
Researchers carried out a systematic meta-analysis of relevant studies from Canada and Europe. They extracted data on myocardial infraction (heart attacks) as an outcome and also recorded drug prescriptions in these patients. Information on 446,763 individuals was collected.
The investigators then used Bayesian modelling to interpret the data that had been collected. Bayesian modelling is a type of statistical analysis used when researchers have incomplete data. It basically fills in the gaps using probability or best guess. Bayesian computer modelling can certainly be useful for policy makers and economists, but is taken with a pinch of salt by clinical doctors (much like the weather forecasters).
The study showed that non steroidal anti-inflammatories drugs including ibuprofen and naproxen were associated with an increased risk of acute myocardial infraction. The Bayesian model suggested that the risk of myocardial infarction was greater during the first month of pain killer use and at higher doses of medication.
There are two major problems with the study. Firstly, the study used Bayesian ‘best guess’ computer modelling. Secondly, the study showed an ‘association’ between pain killers and heart attacks and not ‘causation’. This means that people who had heart attacks were more likely to be on painkillers. However, it does not mean that the painkillers actually caused the heart attack.
The study shows that the heart attacks and use of non steroidal inflammatory drugs happened in the same patients. It does not have anything to say about painkillers causing heart attacks
In summary, there is no convincing evidence to suggest that painkillers such as ibuprofen or naproxen increase the risk of heart attacks within a week.