1. Section Editor(s): Pfeifer, Gail M. MA, RN

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Hypertensive patients with coronary heart disease should avoid nonsteroidal antiinflammatory drugs (NSAIDs). Such patients are at increased risk for death and nonfatal myocardial infarction (MI) and stroke, according to a report in the July 2011 issue of the American Journal of Medicine. The study followed 882 chronic NSAID users and 21,694 nonchronic NSAID users (two-thirds of whom never used NSAIDs) for a mean of 2.7 years. Chronic NSAID users had a 47% higher risk of death or nonfatal MI or stroke, including a 90% increase in all-cause mortality, a 126% increase in cardiovascular deaths, and a 66% increase in total MIs. It's unknown whether specific NSAIDs raise these risks. "Among coronary artery disease patients with hypertension, chronic self-reported use of NSAIDs was associated with harmful outcomes, and this practice should be avoided where possible," write the authors.