BOSTON, MA — Cardiovascular side effects aren't limited to the use
of the newer painkillers called COX-2 inhibitors-a category that
includes Celebrex and the recently discontinued Vioxx and Bextra. Old
standbys, like ibuprofen and aspirin, aren't entirely blameless,
reports the October 2006 issue of the Harvard Heart Letter. The cardiovascular risks associated with traditional NSAIDs are small, but worth being aware of.
aspirin, and COX-2s all belong to the class of medicines called
nonsteroidal anti-inflammatory drugs (NSAIDs). Most of them boost blood
pressure and can counteract the effect of some blood-pressure drugs.
They can also impair blood vessels' ability to relax and may stimulate
the growth of smooth muscle cells inside arteries. All these changes
can contribute to the artery-clogging process known as atherosclerosis.
have determined that use of a COX-2 inhibitor increases the chances of
having a heart attack. Vioxx, which was taken off the market because of
possible heart complications, may lead to or worsen heart failure-but
so can traditional NSAIDs. In general, cardiovascular side effects are
most likely to happen in people with existing heart disease or those at
high risk for it.
The Heart Letter offers a
simple table to help people make an informed choice about pain
relievers. That choice depends in part on whether you are also taking
aspirin to protect your heart. If NSAIDs upset your stomach, try taking
them along with an acid blocker. If you don't get relief from a
traditional NSAID and you don't have heart disease or its risk factors,
don't rule out a COX-2 inhibitor.