Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2011 Jul;124(7):614-20.
doi: 10.1016/j.amjmed.2011.02.025. Epub 2011 May 18.

Harmful effects of NSAIDs among patients with hypertension and coronary artery disease

Anthony A Bavry  1 , Asma Khaliq, Yan Gong, Eileen M Handberg, Rhonda M Cooper-Dehoff, Carl J Pepine
Affiliations

Harmful effects of NSAIDs among patients with hypertension and coronary artery disease

Anthony A Bavry et al. Am J Med. 2011 Jul.

Abstract

Background: There is limited information about the safety of chronic nonsteroidal anti-inflammatory drugs (NSAIDs) in hypertensive patients with coronary artery disease.

Methods: This was a post hoc analysis from the INternational VErapamil Trandolapril STudy (INVEST), which enrolled patients with hypertension and coronary artery disease. At each visit, patients were asked by the local site investigator if they were currently taking NSAIDs. Patients who reported NSAID use at every visit were defined as chronic NSAID users, while all others (occasional or never users) were defined as nonchronic NSAID users. The primary composite outcome was all-cause death, nonfatal myocardial infarction, or nonfatal stroke. Cox regression was used to construct a multivariate analysis for the primary outcome.

Results: There were 882 chronic NSAID users and 21,694 nonchronic NSAID users (n = 14,408 for never users and n=7286 for intermittent users). At a mean follow-up of 2.7 years, the primary outcome occurred at a rate of 4.4 events per 100 patient-years in the chronic NSAID group, versus 3.7 events per 100 patient-years in the nonchronic NSAID group (adjusted hazard ratio [HR] 1.47; 95% confidence interval [CI], 1.19-1.82; P=.0003). This was due to an increase in cardiovascular mortality (adjusted HR 2.26; 95% CI, 1.70-3.01; P<.0001).

Conclusion: Among hypertensive patients with coronary artery disease, chronic self-reported use of NSAIDs was associated with an increased risk of adverse events during long-term follow-up.

PubMed Disclaimer

Conflict of interest statement

Conflict of Interest: Drs. Bavry, Khaliq, and Gong have no financial disclosures.

Figures

Figure 1
Figure 1
Systolic and diastolic blood pressure over time by nonsteroidal anti-inflammatory group. P < .05 for all time points, except for diastolic blood pressure at 30 months (P = .12) and 36 months (P = .41). NSAID = nonsteroidal anti-inflammatory drug.
Figure 2
Figure 2
Kaplan-Meier curves for the time (years) to first occurrence of the primary outcome by nonsteroidal anti-inflammatory group (adjusted hazard ratio = 1.47; 95% confidence interval, 1.19–1.82; P = .0003). NSAID = nonsteroidal anti-inflammatory drug.
Figure 3
Figure 3
Adjusted hazard ratios for the primary outcome in the 2 treatment groups as a function of mean systolic blood pressure. NSAID = nonsteroidal anti-inflammatory drug.
See this image and copyright information in PMC

Comment in

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Bombardier C, Laine L, Reicin A, et al. Comparison of upper gastrointestinal toxicity of rofecoxib and naproxen in patients with rheumatoid arthritis. VIGOR Study Group. N Engl J Med. 2000;343:1520–1528. - PubMed
    1. Bresalier RS, Sandler RS, Quan H, et al. Cardiovascular events associated with rofecoxib in a colorectal adenoma chemoprevention trial. N Engl J Med. 2005;352:1092–1102. - PubMed
    1. Solomon SD, McMurray JJ, Pfeffer MA, et al. Cardiovascular risk associated with celecoxib in a clinical trial for colorectal adenoma prevention. N Engl J Med. 2005;352:1071–1080. - PubMed
    1. Juni P, Nartey L, Reichenbach S, Sterchi R, Dieppe PA, Egger M. Risk of cardiovascular events and rofecoxib: cumulative meta-analysis. Lancet. 2004;364:2021–2029. - PubMed
    1. Solomon SD, Wittes J, Finn PV, et al. Cardiovascular risk of celecoxib in 6 randomized placebo-controlled trials: the cross trial safety analysis. Circulation. 2008;117:2104–2113. - PMC - PubMed

Publication types

MeSH terms