Safety Concern for Chronic NSAID Users With HTN, CAD

Chronic NSAID use tied to increased risk of all-cause death, myocardial infarction, stroke

MONDAY, July 18 (HealthDay News) -- Chronic, self-reported use of nonsteroidal anti-inflammatory drugs (NSAIDs) is associated with an increased risk of adverse events in patients with hypertension and coronary artery disease, according to a study published in the July issue of The American Journal of Medicine.

Anthony A. Bavry, M.D., M.P.H., from the University of Florida in Gainesville, and colleagues investigated the safety of chronic NSAID use among patients with hypertension and coronary artery disease who participated in the International Verapamil Trandolapril Study (INVEST). Patients who reported NSAID use at each visit were classified as chronic NSAID users, and occasional or never users were classified as nonchronic users. The primary outcome was a composite of all-cause death, nonfatal myocardial infarction, or nonfatal stroke.

The investigators identified 882 chronic NSAID users and 21,694 nonchronic users (comprised of 14,408 never users NSAIDs and 7,286 intermittent users). The primary outcome occurred significantly more often in patients in the chronic NSAID group compared to the nonchronic group (rate of events per 100 patient-years: 4.4 versus 3.7, respectively; adjusted hazard ratio [HR], 1.47). This increased rate of occurrence was due to a significant increase in cardiovascular mortality (HR, 2.26).

"Among coronary artery disease patients with hypertension, chronic self-reported use of NSAIDs was associated with harmful outcomes," the authors write.

Several authors disclosed financial ties to the pharmaceutical industry, including Abbott Laboratories, which funded the INVEST study.

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