In a new study, researchers find the commonly used painkiller diclofenac is linked to a higher risk of major cardiovascular events, such as heart attacks and stroke.
Diclofenac is a traditional non-steroidal anti-inflammatory drug (NSAID) to treat pain and inflammation. It is widely used across the world.
Its cardiovascular risks compared with other traditional NSAIDs have never been examined in large clinical trials.
In the current study, the researchers examined the cardiovascular risks of using diclofenac compared with no NSAIDS, starting using other traditional NSAIDs, and starting paracetamol.
They examined the national registry data for more than 6.3 million adults in Denmark with at least one year of continuous prescription records before study entry in January 1996.
Participants were split into low, moderate, and high baseline cardiovascular risk.
Their average age was 46-49 years among participants starting NSAIDs and 56 years among those starting paracetamol.
The authors found that starting diclofenac during the study period was linked to an increased rate of cardiovascular diseases within 30 days, compared with starting other traditional NSAIDs (ibuprofen or naproxen) or starting paracetamol.
The diseases included irregular heartbeat or flutter, ischaemic stroke, heart failure, and heart attack.
The increased risks applied to men and women of all ages and also at low doses of diclofenac.
In addition, using diclofenac was also linked to a higher risk of cardiac death compared with no NSAIDs.
It was also linked to an increased risk of upper gastrointestinal bleeding compared with no NSAIDs, starting ibuprofen or paracetamol, but not with naproxen.
The researchers suggest that diclofenac should not be available over the counter, and when prescribed, it should be accompanied by an appropriate front package warning about its potential risks.
The research team is led by Morten Schmidt at Aarhus University Hospital in Denmark.
The study is published in The BMJ.
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Source: BMJ.
