Typical Painkillers Associated With Higher Cardiac Arrest Risk

You may want to think twice before popping that "harmless" painkiller.

Typical painkilling medications like ibuprofen have been linked to a higher risk for cardiac arrest – aka when your heart abruptly stops working, according to a new study from Denmark published Wednesday in European Heart Journal – Cardiovascular Pharmacotherapy. Ibuprofen, sold over-the-counter in both generic form and under brand-name Advil, is a member of the class of medications called non-steroidal anti-inflammatory drugs, otherwise known as NSAIDs.

Researchers used data from the Danish Cardiac Arrest Registry to discover out-of-hospital cardiac arrests from 2001 to 2010, which tallied 28,947 patients, and looked at filled NSAID prescriptions at Danish pharmacies going back to 1995. The NSAIDs prescribed included non-selective ones like ibuprofen and diclofenac (what you may know as Voltaren) and selective ones like rofecoxib (think Vioxx).

As many as 30 days before suffering cardiac arrest, 3,376 of these 28,947 patients used an NSAID. Taking any NSAID meant a 31 percent increased risk of cardiac arrest, with ibuprofen linked to a 31 percent higher risk and diclofenac a 50 percent greater risk. Other NSAIDs such as naproxen (sold over-the-counter in the U.S. as Aleve), celecoxib and rofecoxib were not linked to cardiac arrest events though the authors think this had to do with the fact they're not widely prescribed in Denmark and thus underrepresented in the study, according to an article in Time.

Over-the-counter drugs were not a part of the study; the sole over-the-counter NSAID in Denmark is 200-mg tablets of ibuprofen.

"The findings are a stark reminder that NSAIDs are not harmless," study co-author Gunnar H. Gislason said in a news release. "Diclofenac and ibuprofen, both commonly used drugs, were associated with significantly increased risk of cardiac arrest. NSAIDs should be used with caution and for a valid indication. They should probably be avoided in patients with cardiovascular disease or many cardiovascular risk factors."

The study's overarching limitation is that it was observational, among other caveats. The drug use information came from Danish pharmacies and researchers didn't know if people fully complied with the instructions on taking their medications, though they "assume that non-compliance had little influence on [their] results," according to the study.

Dr. Christopher O'Connor, editor-in-chief of the American College of Cardiology journal JACC – Heart Failure, notes in an interview with Time that the majority of cardiac arrest cases in the study involved older people who already had risk factors.

"I don't want my 20-year-old son who twists his ankle playing soccer to walk around in pain because he's scared to take ibuprofen," O'Connor told Time.

He thinks the idea is to proceed with caution.

"I would say the message here is to be careful taking nonsteroidals, particularly high doses, and particularly if you have a preexisting cardiovascular disease," he told Time.