Vascular and Upper GI Effects of Pain Killers Explored.

Major vascular events were increased by about a third due to the use of a Cox-2 inhibitor (COXIB) or diclofenac, both nonsteroidal anti-inflammatory drugs (NSAIDs), in a recent meta-analysis of more than 750 trials. Ibuprofen, but not naproxen, also significantly increased major coronary events. Vascular death was increased by 58% with COXIB and 65% with diclofenac, but it was not significantly increased by ibuprofen or naproxen. Heart failure risk was roughly doubled by all NSAIDs, and all NSAID regimens increased upper gastrointestinal complications. The findings are published in The Lancet.