Introduction

Seniors who take non-steroidal anti-inflammatory medications (NSAIDs), other than low-dose aspirin, have twice the risk for being admitted to the hospital with congestive heart failure (CHF). And the odds are greater for those with a history of heart disease, according to this Australian study.

Study Design

Researchers studied 365 patients who were admitted to hospital with congestive heart failure (CHF) for the first time to determine whether taking NSAIDs increased their risk for this event. To determine the risk, patients admitted to the hospital with CHF were compared to 658 "controls" of similar age admitted to the same hospital without CHF. The researchers also looked at whether the risk was greater in people who already had history of heart disease, and how the risk changed according to the NSAID dose and the length of time the drug stayed in the body. The likelihood of increased risk was expressed as an 'odds ratio' (OR), which was adjusted for other factors that might influence the results.

Results

First, all the patients admitted with CHF were compared with the controls to determine the odds for being admitted to the hospital with congestive heart failure. Taking an NSAID (other than aspirin) in the prior week was associated with a doubling of the likelihood of admission with CHF (OR of 2.1).

Researchers then assessed the risk for patients who were admitted to the hospital with CHF for the first time. They compared first-time CHF patients who had a history of heart disease to first-time CHF patients without a history of heart disease. In those with a history of heart disease, the likelihood of being admitted to the hospital for the first time with CHF was 10.5 times that of the controls, compared to a 1.6 times likelihood for those without a heart disease history.

For patients with a history of heart disease, the dosage of their NSAID medication significantly increased the odds for being admitted to the hospital for the first time with CHF - the OR increased by 7.5 for each major increase in dosage. Use of NSAID medications that, because of their metabolism, stayed longer in the body, also increased the odds of first-time hospital admission for CHF.

Statistical analyses showed that all the above findings were significant.

Conclusions

The authors of the study calculate that approximately 19% of hospital admissions for CHF among seniors may be due to the use of NSAID medications. They conclude that NSAIDs should be used with caution by patients with a history of heart disease. Certainly, the findings are sufficiently worrying that they require confirmation (or denial) in further studies.

If you take NSAIDs (e.g. ibuprophen, diclofenac, full-dose aspirin) on a regular basis, be sure to let your physician and other health care professionals who care for you know how often and how much of them you use, especially if you have an existing heart problem.