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NSAIDs: How dangerous are they for your heart?
- By: Christian Ruff, MD, MPH, Contributor
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I feel that a lot of people are under the impression that NSAID’s help with dealing with heart disease. On the contrary, high doses and long term use can increase the likelihood of cardiovascular disease or another heart attack. Anyone who is taking NSAID’s for a long period of time should keep an eye on their health even if they are not experiencing symptoms.
I’ve seen a few reports that they can also lead to testicular cancer, causing calcified deposits that could lead to tumours
I had a heart attack 2 years ago at age 28. My cardiologist attributed my event to prolonged NSAID and decongestant use. I was one of the rare cases I guess.
I was diagnosed with Ankylosing Spondylitis some 20 years ago. At one point, my Rheumatologist suggested that I try a new type of medication that was becoming available – called TNF alpha blockers. Not wanting to be a guinea pig, I turned that down and sure enough, a few years ago, I read that TNF alpha blockers have been associated with increased risk of cancer.
My doctor suggested for me to atleast be on a regular dosage of Naproxen. When I told him that I take it only when I had pain, he thought that was silly and couldnt understand why I wouldnt take this safe medication. Now we hear about all these heart risks.
Goes to show that we need to take all these expert opinions with a generous does of skepticism. Not that the individual doctors are wrong – but, the way western medicine is practiced it seems we develop these narrowly focused “solutions” without understanding the impact to the overall system of human body.
What would you recommend for chronic arthritis in knees?
For patients with no history of cardiovascular disease the choice of NSAIDs probably does not matter very much. For patients with a history of cardiovascular disease we generally recommend I generally recommend the naproxen or celecoxib,
I’ve often heard that for an NSAID to provide effective therapy for an injury, it should be taken regularly, around the clock, for the recommended treatment period. Does that pose greater risk than taking it intermittently and, if so, how do we get around the need to take it regularly?
Yes.. that is correct. For acute injuries a short course of taking NSAIDs are regular dosing intervals are necessary to alleviate pain and inflammation. This generally poses minimal risk to most patients. Of more concern is when patients are taking large doses of NSAIDs regularly chronically (months to years).
It is a great question. Aspirin is protective for the heart because it only effects platelet function. Basically preventing platelets from clumping together to form blood clots. While there is some overlap between the platelet effects of NSAIDs and aspirin, NSAIDs have have other effects on the lining of blood vessels which may actually predispose to clots to forming clots which can result in heart attacks or strokes. NSAIDs can also cause the kidneys to retain salt and water which may cause or exacerbate heart failure.
You hear all this stuff about NSAIDs being bad for heart patients but nobody ever says what it does and why doesn’t aspirin pose the same threat what is the actual mechanical function that is harmful not enough to just tell me it’s bad
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