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Chiropractic Research Review

NSAIDs May Contribute to Congestive Heart Failure

Nonsteroidal anti-inflammatory drugs (NSAIDs) have come under fire in recent years, with mounting evidence suggesting possible dangerous side effects associated with their use. Experimental studies have shown that giving NSAIDs to susceptible individuals can lead to the development of congestive heart failure (CHF), an association the authors of this study sought to investigate further.

Patients admitted to hospitals with a primary diagnosis of CHF (365 cases) were compared with patients without CHF (658 cases) who were admitted to the same hospitals for other conditions.

Patients were interviewed to gather data on recent use of aspirin and other NSAIDs.

Results: Use of NSAIDs in the week prior to admission to the hospital for CHF doubled the odds of a CHF hospital admission. Additionally, the odds of a first admission to the hospital for CHF were positively related to the dose of NSAIDs consumed in the previous week.

Why this relationship occurs is unknown. The authors state that NSAIDs produce hemodynamic changes which may partially account for this relationship. Also, NSAIDs are known to alter the function of diuretic drugs and ACE inhibitors, pharmaceuticals commonly used by patients with heart problems. It is possible that the increased risk for hospital admission for CHF may be attributed to these drug interactions.

The authors conclude that NSAIDs were responsible for approximately 19% of hospital admissions with CHF, and emphasize that "NSAIDs should be used with caution in patients with a history of cardiovascular disease."

Page J, Henry D. Consumption of NSAIDs and the development of congestive heart failure in elderly patients. Archives of Internal Medicine, March 27, 2000:160, pp777-784.

Chiropractic Research Review

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