Blood Pressure ans NSAIDs

I am a 49 year old male with a history of OA in my knees and recently dx with RA as well. Other than being about 50 pounds overweight (have lost 60 in 18 months) no real issues. My blood pressure is controlled with Benicar HCT 40mg and is steady at 110/70, my TC is 151 with HDL of 40 and LDL at 58, but tri's are still on the high side. No family history of early onset CAD, don't smoke and exercise daily, 45 -60 minutes on a treadmill, no symptoms at all. I have had two thallium stress tests in 2005 & 2006 that were negative, echos each of the past three years and all have been normal. I got the tests because of some mild chest pain I had back in 2005 which turned ot to be reflux and my doctor wanted to be safe and check it out but left me with some health anxeity so I had cardiac workups each of the past three years, last one this past September and all have been normal. My cardiologist even told me that regular visits were no longer necessary and to let my family doctor manage my care, which I guess is a good thing, and on the positive side it lead to some lifestyle changes that have helped considerably. My current concern is that my Rheumatologist wants me on Celebrex for the arthritis and I know it carries a risk of increased cardiac events and raises blood pressure. I've worked very hard to get my blood pressure under control and really don't want the increased risk either. I have two quesions, first are there any good alternatives out there and second is there any new information that shows a verifiable link between heart disease and NSAIDs? I know there have always been warnings but it never really seemed conclusove. I need to do something, the pain from the arthritis is getting intolerable.

Thanks!

Jon

[Cleveland Clinic]

The story with NSAIDS is that they interfere with the effect of aspirin and may inhibit production of some favorable cytokines.  The story with vioxx which is now taken off the market because of increased risk of heart attack, is that it was a very powerful inhibitor of COX-2 enzyme.  Celebrex is not as strong an inhibitor of COX-2 and may be a safer alternative in patients like you.  The only way to know that for sure, is to do a prospective study.  There is an ongoing study which addresses exactly that situation.  We don't have the results yet, and it may be a few years before we know for sure.