Prolonged use of over-the-counter pain relievers can affect your heart in detrimental ways. Chrys Peterson sat down with cardiac electrophysiologist Kamala Tamirisa, MD, FACC, FHRS, to learn more.
Chrys Peterson: What are NSAIDs?
Dr. Kamala Tamirisa: NSAIDs are nonsteroidal anti-inflammatory drugs. They’re available over-the-counter and they are commonly used for pain—whether it’s joint pain, headaches, or migraines.
So these would be things we would take like Motrin and ibuprofen. How do they affect the heart?
We don’t know the exact mechanism, but we know that these medications inhibit certain enzymes via receptors, and these enzymes are actually released as a protective mechanism in response to a cellular injury. So if you inhibit the protective enzyme release, then you lose the benefit of having those protective enzymes in your body, which protect from having a heart attack, stroke or heart failure.
So they can interfere with what your body’s naturally doing to keep your heart going and keep your heart healthy. How long is too long to take these drugs? Are you talking about weeks and months of use?
Looking at the data, the usual recommendation is not to use NSAIDs more than once or twice a day for a prolonged time, which is probably a couple of weeks or ten days. Avoid using them at higher doses, and keep the dosage to one or two pills a day. If someone has severe arthritis, and they have to take these on a day-to-day basis, then we tell them to take a holiday from the tablets for about a week or so and then you can take them again. It’s very important to talk to your regular physician about it.
Right. We need to make sure that all the physicians are in concert about what drugs you’re taking and how they may be affecting each part of your body. What about aspirin? I know cardiologists sometimes prescribe a baby aspirin or aspirin for someone with heart issues. Is that also an NSAID?
It is an NSAID, but aspirin taken at a lower dose, at a safe dose, such as one pill a day (whether it’s baby aspirin, which comes at 81mg or 325mg for an adult dose of aspirin) gives protection from having a heart attack or a stroke, provided a patient had a heart event in the past. Aspirin is not a good drug to take as a primary prevention medication. So if someone never had a heart attack or a stroke, it’s not a medication that’s going to protect patients from having those events.
So the big thing is just to make sure if you are taking these NSAIDs, these over-the-counter pain relievers, that you make sure that you’re talking to your family doctor and making sure that all your physicians are in concert about how that may be affecting your body.