NSAIDS

I am experiencing increased pain from RA and visited my Rheumatologist this week and he put me on Celebrex which has been linked to heart disease. My understanding is that the risk involves an increase in blood pressure which could result in damage to a vulnerable plaque plus the other obvious issues with high blood pressure. I am a 49 year old male, non smoker, no family history of heart disease, slighlty overweight, normal lipids and controlled high blood pressure with Benicar HCT 40/25, usually under 110/70. I am on an exercise regime that includes 45 minutes on a tread mill daily (with no symptoms while exercising), which is hard on the RA, but has helped me to drop 50 pounds over the last ten months as mentioned in a previous post. I have had normal cardiac work ups with echos and nuclear stress tests the past 2 years (only did them to rule out a cardiac souce for some chest pain that turns out to be RA related). I hate to start with the Celebrex. My questions are 1) exactly how do the NSAIDS drugs cause a risk for heart attack 2) Would you consider them safe with my current condition. I would like the pain relief but also want to keep the old heart safe. This is my 2nd post in six months so it will be my last for a while. Thanks in advance for your input.

Tony

[Forum-M.D.-bkj]

Toneman,

Thanks for the post.

1) exactly how do the NSAIDS drugs cause a risk for heart attack

Unfortunately no one specifically know the answer to this question. There are multiple hypothesis from the increase in blood pressure, increased thrombosis and a direct effect on plaque stability.  There is also variability in each drug.

2) Would you consider them safe with my current condition. I would like the pain relief but also want to keep the old heart safe. This is my 2nd post in six months so it will be my last for a while.

It's impossible to tell you specifically what medicines you should or shouldn't take. Certainly, if your pain symptoms effect your quality of life, then the side effects of any particular medicine may be worth taking. I would discuss your concerns with your physician.

good luck

[Barbarella]

Do you have a BP monitor at home?  Check your BP while on Celebrex.  My husband is on Celebrex for the last 4 yrs and it doesn't effect his BP at all.

Me however, I cannot take Aleve, Advil and the other stuff my BP shoots up 30 points, sometimes even higher.  I never took Celebrex because I figured if Aleve or Advil make my BP go up something stronger than Celebrex would make it go up for sure.

[MLWTR]

Perhaps you might want to try naproxen, if you haven't already. If it works as well as Celebrex for you, it could be a good choice, because studies have found it to be cardiovascularly neutral, i.e., it doesn't increase cardiovascular risk or reduce it. Just a thought.