All NSAID’s Increase Cardiac Risk-New Study
One of our biggest problems in helping patients move from more invasive surgeries to less invasive regenerative interventional orthopedic procedures is NSAID’s. While drugs like Motrin, Ibuprofen, Aleve, Naprosyn, Advil, and Celebrex are very good at reducing inflammation and pain, they have serious side effects. Everyday we see a class of patients who seem to be less likely to do well with regenerative interventional orthopedic procedures; these patients are so dependent on NSAID’s for normal functioning that the prospect of getting off NSAID’s is untenable. These are usually middle aged and physically active patients who have learned to consume large amounts of NSAID’s to be able to stay active. We usually want them off of these NSAID drugs because they have been shown to reduce the body’s ability to heal. Now there may be a new reason to get them off. In a very concerning study published this week, it was shown that all NSAID’s (anti-inflammatory drugs) increase the risk of having a serious cardiac event-with Napsosyn (Alleve), increasing cardiac risk the least. If we take the least concerning of the bunch (Alleve-Naprosyn), this medication increased cardiac risk by a whopping 82%! The worst of the bunch was Vioxx (followed closely by Celebrex) which increased the risk of a having a serious heart problem by 202%! Considering that the average cardiac risk reduction in exercise studies is a more modest 30-50%, just being “addicted” to the least harmful NSAID to stay active, erases the heart benefit of being active and still likely adds some cardiac risk on top of that! What to do? There is an excellent study published by one of our neurosurgeon patients, Joe Maroon, M.D. from the University of Pittsburgh showing that he was able to get many chronic low back pain patients off NSIAD’s by placing them on a high quality fish oil (Fish oil has heart benefits, check out this fish oil and heart failure study). In my experience, you can also get some benefit from going on a low glycemic diet to reduce insulin resistance, which has been tied to chronic inflammation. Another method may be the supplement resveratrol, which regulates genes to control insulin resistance and reduce inflammation. In conclusion, like any drug “addiction”, “stay off the sauce” and get your problem checked by a qualified professional to solve the issue, rather than mask the pain and symptoms.