RESEARCH - NSAID use may raise risk of hospitalization for heart failure

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NSAID Use May Raise Risk of Hospitalization for Heart Failure

NEW YORK (Reuters Health) Nov 03 - Current NSAID use is associated with a

slightly increased risk of a first hospitalization for heart failure,

according to a report in the November issue of Heart. Similarly, NSAID use

may worsen preexisting heart failure.

The new findings, which stem from a case-control analysis, agree with those

of epidemiologic studies linking NSAID use with increased risks of incident

heart failure, hospitalization for heart failure, and heart failure relapse.

Researchers believe that by blocking prostaglandin synthesis, NSAIDs

increase systemic resistance and decrease renal perfusion, both of which

would be expected to increase the risk of heart failure.

As reported in the November issue of Heart, Dr. Consuelo Huerta, from the

Centro Espanol de Investigacion Farmacoepidemiologica in Madrid, Spain, and

colleagues assessed NSAID use among 1396 patients with a first

hospitalization for heart failure (from 1997 to 2000) and 5000 controls who

were entered in the UK General Practice Database.

The rate of first hospitalization for heart failure was 2.7 per 1000

person-years, the report indicates. The strongest risk factor for a first

hospitalization was a prior diagnosis of heart failure, which raised the

likelihood by 7.3-fold.

After adjusting for various confounders, current NSAID use was associated

with a 30% increased risk of first hospitalization for heart failure, the

authors note. No dose or duration effects were noted.

Current NSAID users with preexisting heart failure were 8.6-times more

likely to have a first hospitalization for heart failure than nonusers

without this medical history.

" Heart failure is a common cause of morbidity and mortality in the elderly

and even a small increase in the risk can translate into a significant

disease burden in the general population, " the investigators write.

" Therefore, NSAIDs should be used with caution by patients with a high risk

of hospital admission due to heart failure such as those with prior clinical

heart failure, diabetes, renal failure or treatment with hypertension

drugs. "

Heart 2006;92:1610-1615.

http://www.medscape.com/viewarticle/547180

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