Regular use of the over-the counter pain reliever naproxen raises the risk of a heart attack, stroke and death in postmenopausal women, according to researchers at the University of Florida.
Naproxen is a non-steroidal anti-inflammatory drug (NSAID) that is the active ingredient in Aleve and other OTC pain relievers commonly used to treat arthritis.
In a large study of postmenopausal women, published in the journal Circulation: Cardiovascular Quality and Outcomes, researchers estimated that using naproxen just twice a week or more raises the risk of cardiovascular problems by about 10 percent.
“That is counter to the medical community’s perception of NSAIDs, in which most people believe naproxen to be safer. Our study showed naproxen was not safer — it was actually harmful,” said lead author Anthony Bavry, MD, a cardiologist at the University of Florida.
The study did not find a higher risk of a heart attack, stroke and death associated with ibuprofen, another type of NSAID.
Working with researchers from Harvard and other universities, Bavry combed through data on over 160,000 postmenopausal women collected by the Women’s Health Initiative — a 15-year research study funded by the National Institutes of Health. It’s the first large study to examine the effects of regular NSAID use on women.
“When we study agents such as aspirin, we have found differential effects in men and women,” said Marian Limacher, MD, the UF principal investigator for the Women’s Health Initiative. “Men had reduction in heart attack, and older women had a reduction in stroke but not heart attack, which is part of the reason those of us studying women feel we really need to have adequate information on commonly used drugs for both men and women.”
Naproxen and other NSAIDs relieve pain by inhibiting enzymes responsible for inflammation, but they can cause bleeding in the stomach and digestive tract. A newer generation of NSAIDs — COX-2 inhibitors – were developed to reduce gastrointestinal side effects, but were also found to increase the risk of cardiovascular problems.
The COX-2 inhibitor rofecoxib, sold under the brand name Vioxx, was taken off the market in 2004 because of its association with an increased risk of heart attack or stroke at high doses.
Bavry thinks the culprit in naproxen is also COX-2 inhibition.
“People will have to think about what they have in their own medicine cabinet. Do they have naproxen, ibuprofen or something else?” said Bavry.
A large study published last year in the journal The Lancet found that high doses of naproxen and other NSAIDs increase the risk of heart problems by about a third. People with existing heart problems or other risk factors had an even higher risk of complications from NSAIDs.
Another recent study by Dutch researchers found that NSAIDs may significantly increase the risk of atrial fibrillation – an irregular heartbeat — in adults aged 55 and older.