Been gone for awhile and noted this post. I love Advil for great pain relief but I am thinkinbg this med now has worsened feet swelling. Docs always said feet swelling is cosmetic but I feel they are wrong. I see Eric Topols's name mentioned here. I have read many articles that he has written on just about everything and this man is very informative and has taught me a lot. He stands for what he beleives and I like that in a doctor. I wish he were here in Texas.
I was kind of wondering what exactly it is about the NSAIDs that increase cardiovascular risk. I knew about the general heart attack/stroke risks associated, but I've also heard that people with CHF should not take ibuprofen, so it made me wonder if there was more to it. Apparently NSAIDs can increase CHF symptoms?
I think ibuprofen is an awesome drug when I get severe pain (read: so bad I can't do anything unless I take an Advil...happens two, maybe three times a year and is usually a headache) but I've suffered through whatever the pain was since hearing about the detrimental effects it can have - both on the cardiovascular system and on the GI system. To me, not worth it.
Thanks! That also explains why it causes CHF symptoms to increase (fluid load). One of the primary goals of CHF management is to reduce fluid load, since the heart is less capable of handling it with reduced function. Great info!
NSAIDS are what is known as a COX-2 inhibitors and the basic problem is that they will make you retain water thus increasing the volume of your blood and fluid load which results in increased blood pressure. If someone already has high blood pressure, a NSAID will just increase the problem plus it may counteract some high blood pressure medications that include diuretics. Also, if you have a vulnerable plaque in one of your arteries, the sudden increase in blood pressure could cause a rupture which would normally lead to an MI.
The most dangerous NSAID was Vioxx, which was a COX-1 inhibitor, which is still an NSAID, but had a much higher risk for heart issues which is why it was pulled from the market. The new COX-2 inhibitors don't have as high a risk, but it is still there.
Jon
Hi Jon,
Very good and important questions.
Any NSAID increases the risk of cardiovascular events with Vioxx being one of the biggest culprits (as pointed out by our very own Dr. Eric Topol in JAMA about 4 years before anyone paid attention to it). There is a continuum of risk down to and including ibuprofen. The risk is relatively low, but there is still risk. Everyone needs to understand is that every medications has risk and benefits. The theurapeutic window from some medications is great and even saves lives -- like statins for people with coronary artery disease. Other medications like NSAIDs make important contributions to quality of life, but carry the risk of increased cardiovascular events like heart attacks and stroke. There is no easy answer. what I tell my patients is that they need to decide how much the medication improves their symptoms. If it is not worth living without the benefit of decreased knee pain, there is probably worth the slight increased risk of cardiovascular events. It is not an easy decision.
NSAIDs can increase blood pressure and some NSAIDS like ibuprofen (Advil) have been shown to decrease the beneficial effects of aspirin for cardiovascular disease.
Your overall risk of cardiovascular events with Celebrex is low, but it is probably higher than if you were not taking the medication. Unfortunately this is not a yes or now questions.
I hope this answers your question. Good luck and thanks for posting.