Painkillers linked to higher stroke risk

Older people using non-steroidal painkillers face an increased risk of stroke, a study shows.

An analysis of the medical records of 162,000 Australian veterans found those taking prescribed non-steroidal anti-inflammatory drugs (NSAIDs), often used for joint pain, increased their chances of having a stroke by 1.88 times.

Lead researcher Gillian Caughey, of the University of South Australia, said while the increased risk was low doctors should still consider it when prescribing NSAIDs for older people.

"At least a third of the older population will have cardiovascular disease (CVD) and 20 per cent will have comorbid arthritis and CVD, meaning that NSAIDs will commonly be used by patients who are at risk of future cerebrovascular events," she wrote in the study, published in The Medical Journal of Australia on Monday.

"Individual assessment of cardiovascular risk, careful deliberation of the balance between risk and benefits and appropriate supervision is required when initiating NSAID therapy.

"Enhanced patient awareness of the potential for serious adverse cardiovascular events with all NSAIDs may also attenuate risk."

The research adds to previous overseas studies which have linked NSAIDs to increased risks of various cardiovascular problems.

One widely used NSAID, rofecoxib, was withdrawn from sale around the world in 2004 amid concerns about the increased risk of heart attack and stroke for those using it in high doses for long periods.

The Australian study looked at the links between hospitalisation for stroke and veterans who had been prescribed NSAIDs between 2001 and 2008.

It found the absolute risk of stroke among the group was low at 7.1 strokes per 1000 people a year.

However, there was a 1.88 times increased risk of hospitalisation for stroke after veterans began taking prescribed NSAIDs.

Dr Caughey said the increased risk equated to an absolute risk of 13.4 strokes per 1000 people a year.

She added that an increased risk of stroke was also found for veterans taking the commonly used NSAID diclofenac, which is available without a prescription.

Dr Caughey said diclofenac was found to pose a similar risk of stroke to that of rofecoxib.