Arthritis and heart disease – a deadly combination?
NSAIDs are the mainstay of arthritis treatment, but their use for prolonged periods unfortunately carries certain risks.
• Kidney problems – such as decreased urine production – are usually reversible, but long-term NSAID use may lead to permanent kidney damage.
• Fluid retention from NSAIDs can raise blood pressure.
• Underlying heart disease/heart failure may worsen (partly on the basis of worsened blood pressure), and some NSAIDs have been associated with such a significant increase in heart attacks that they have been withdrawn from the market.
• The anti-platelet effect of aspirin may be inhibited: relevant for patients with heart disease
• In heart failure (HF) patients, NSAIDs may reduce the response to HF therapy, (e.g. ACE inhibitors and diuretics) and thus increase mortality.
The accepted recommendation for NSAID therapy is that an appropriate agent should be chosen and used at the lowest effective dose for the shortest possible time.