Cardiovascular Risk of NSAIDS- Clinical implications
Pain is a distressing feeling and is the commonest symptom in clinical practice. It affects the quality of life. Sleep can be disturbed. The International Association of Pain defines pain as unpleasant sensory and emotional experience associated with actual or potential tissue damage. Pain can interfere with quality of life and general functioning. In elderly, musculo-skeletal pain is very common and demands pain relief with analgesics. NSAIDS are commonly prescribed. Elderly subjects usually have associated disorders like hypertension and diabetes, which are established risk factors for cardiovascular disease. Regular usage of NSAIDS can further increase this risk.
Sharma S et al (1) reported in a study that 13% of patients suffering from cardiovascular disease taking NSAID experienced either exaggeration in their symptoms or developed new cardiovascular complications over time. The cardiovascular events were myocardial infarction, severe left ventricular failure, atrial fibrillation, re-infarction development and increase of blood pressure by 5mm of Hg. Pawlosky et a(2) demonstrated that even short-term use of NSAIDs for less than 90 days could increase the risk of serious coronary conditions.
Dr.S.Ramnathan Iyer- MD (Medicine), FRCP (Glasgow),FICP,FGSI,FISDA,FISH, Consultant Physician- Sleep Medicine, Ambika Clinics- Dombivli (East), Dist. Thane and Kharghar, Navi Mumbai, Visiting Consultant-Sleep Medicine, Godrej Memorial Hospital, Vikhroli (East), Mumbai