Health
Pain relievers associated with heart failure in patients with type 2 diabetes
Researchers and clinicians know that people with type 2 diabetes face high prices. risk of heart failure. Even without cardiology diagnosisthey have more than twice the risk of developing heart failure compared to the general population. Research so far.
New research suggests taking common pain relievers such as Advil and Motrin (ibuprofen) may increase that risk even further.
Use of non-steroidal anti-inflammatory drugs (NSAIDs) was associated with first hospitalization for heart failure in people with type 2 diabetes in the short term, a new study reveals. Research published in Journal of the American College of Cardiology.
NSAIDs are known to be associated with cardiovascular risk and are generally not recommended for people with known heart disease. The study suggests that it may be prudent to extend the recommendations to people with type 2 diabetes, even those without a diagnosis of heart disease, although more research is needed.
NSAID use is prevalent in people with type 2 diabetes
A Danish study of 330,000 people with type 2 diabetes found that about 1 in 6 filled at least one NSAID prescription within a year.This fact alone is noteworthy, says lead author Anders Holt, M.D.of Copenhagen University Hospital, Denmark.
“One of the more surprising findings for me was the high prescriptive NSAID use in the diabetic population, a group of patients with well-established cardiovascular risk,” Dr. Holt said. says.
NSAIDs increase heart failure risk by 40%
Investigators used a Danish registry to identify people diagnosed with TD2 between 1998 and 2021. The average age he was 62 years old and 44% were female. People diagnosed with heart failure or those with rheumatic conditions requiring long-term NSAID use were excluded from the study.
Within the first year of study participation, 16% of subjects filled at least one NSAID prescription and 3% filled at least three prescriptions.Ibuprofen was the most common (12.2%), followed by Diclofenac (3.3%), naproxen (0.9%), and Celecoxib (0.4%). (Unlike America, research It indicates that NSAIDs are commonly prescribed in Denmark rather than purchased over the counter. )
During a median follow-up period of approximately six years, more than 23,000 study participants were hospitalized for the first time with heart failure.
NSAID use was associated with a 40% higher relative risk of first heart failure hospitalization. An individual analysis of his NSAIDs showed an increased risk of hospitalization for heart failure after use of diclofenac or ibuprofen, but not celecoxib and naproxen.
The researchers also looked at the risk of heart failure from NSAID use in a subgroup of patients.
- They found no association between NSAID use and increased risk in people with well-controlled diabetes.
- A strong association was found in those aged 65 and over, but not in those under 65.
- The strongest associations were seen in very infrequent or new users of NSAIDs.
Data on over-the-counter use of NSAIDs were not included in the study.
NSAIDs may be dangerous for people with type 2 diabetes, even without a previous diagnosis of heart failure
Although this is a single study, it was conducted in a very large patient group with real-world data, making these findings very compelling. Salpy V. Pamboukian, MD, cardiologist at UW Medicine in Seattle, which specializes in advanced heart failure and transplants. Dr. Pambukian was not involved in this research.
“Cardiologists have long recommended avoiding NSAIDs in established patients. Diagnosis of heart failure, because of the risk of progression of renal failure or worsening of heart failure.This study now extends these concerns to people with type 2 diabetes without it A previous diagnosis of heart failure. This is very important,” she says.
NSAIDs are commonly used to relieve headache pain. back pain, and arthritis. The most common drugs in this class are: aspirinibuprofen (Motrin and Advil) and naproxen sodium (Alive).
What is the relationship between NSAIDs and heart failure risk?
according to Centers for Disease Control and Prevention (CDC)Approximately 6.2 million adults in the United States have heart failure. This is a condition in which the heart is not functioning properly. When a person suffers from heart failure, the cells in the body do not get enough blood supply, which can lead to fatigue and exhaustion. difficulty breathingaccording to American Heart Association (AHA).
Before Research published in BMJMore In the general population, current NSAID use (within the past 2 weeks) was found to increase the risk of hospitalization for heart failure by 19% compared to those who had not used an NSAID for at least 6 months. The higher her NSAID dose the person was taking, the higher the risk.
Given the increased risk of heart failure in people with type 2 diabetes, NSAIDs may be even more harmful to this at-risk group, according to the authors.
Findings highlight risks of common pain relievers
NSAIDS are readily available and used by many patients to treat a variety of ailments, but many never consult a doctor.
“These findings underscore the need to educate patients with heart risk factors such as diabetes about the potential risks posed by over-the-counter drugs. Patients can buy them without a prescription.” We assume that drugs are ‘safe’, but as this study shows, even commonly used drugs can pose risks, even for short-term use.” she says.
Patients taking chronic medications should understand that any new medication they take may have interactions or adverse effects, and if they are unsure about the safety of the medication (generally used), you should check with your healthcare provider. Pambukian says.
Age, A1C controls and medications may put some people at very high risk
It’s too early to make clinical recommendations based on these findings alone, and while these findings show an association, they don’t prove that NSAIDs caused an increased risk, says Holt. says.
“However, subgroup analyzes provide interesting insights. Indeed, older patients, NSAID-naive patients, poorly controlled diabetesand RASi (renin angiotensin system inhibitor) and diuretic It seems susceptible to the proposed association. In fact, we didn’t see a significant association in younger patients or in those with better diabetes control,” he says.
Although current data do not support the practice of NSAID treatment if it is well indicated and required, the ‘high-risk’ subgroup is more likely to receive more follow-up, weight reduction, or other palliative strategies. may benefit most from More research is needed. Holt says.
Should T2D patients avoid taking NSAIDs?
Pamboukian is useful not only for diabetes high blood pressure Avoid NSAIDs completely (especially if you are taking other heart medications).
NSAIDs, diuretics, and ACE inhibitor again ARBs — puts patients at a very high risk of heart and kidney failure, she says. “other pain reliever As an alternative to NSAIDS, nonpharmacologic therapies can be considered to treat pain. I tell my patients that life is all about “risk versus benefit” — as long as they are informed, it is ultimately up to the patient to decide whether the benefit of NSAIDs is worth the risk.
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