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Ibuprofen cuts heart benefits of aspirin

A recent study documents that people taking low-dose aspirin to guard against heart disease, stroke and angina should not take ibuprofen at the same time since it may reduce the beneficial effects of aspirin.

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The drug aspirin has repeatedly been found to be protective against cardiovascular diseases and cuts the risk of heart disease by making blood-clotting cells less sticky preventing clot formation. A recent study documents that people taking low-dose aspirin to guard against heart disease, stroke and angina should not take ibuprofen, a non-steroidal anti-inflammatory drug (NSAID), at the same time since it may reduce the beneficial effects of aspirin. Ibuprofen, a hugely popular drug taken to relieve aches and pains, diminishes the benefits of aspirin and can also increase the risk of stomach bleeding. Researchers at the Ninewells Hospital, Dundee, aimed to assess whether patients with known cardiovascular disease (myocardial infarction, angina, stroke or transient ischaemic attack, and peripheral vascular disease) who take low-dose aspirin and ibuprofen have increased risk of cardiovascular mortality. They studied the medical history of 7107 patients with cardiovascular disease who had been discharged from hospital and were taking low-dose aspirin alone or in combination with ibuprofen. Low-dose aspirin is frequently prescribed for secondary prevention of cardiovascular disease. NSAIDs are prescribed widely for relief of symptoms of various diseases, and ibuprofen is also available over the counter. It was found that as compared with those who used aspirin alone, patients taking aspirin plus ibuprofen had an increased risk of all-cause mortality and cardiovascular mortality. They found no increased risk of death in patients taking aspirin and diclofenac, another NSAID.The researchers pointed out that those taking both drugs were doubling their risk of death from any cause compared with patients who took just a low dose of aspirin. It was suggested that treatment with ibuprofen in patients with increased cardiovascular risk may limit the cardioprotective effects of aspirin. They postulated that patients with known cardiovascular disease who take low-dose aspirin and ibuprofen might have increased risk of cardiovascular mortality. When patients taking aspirin for cardioprotection require chronic treatment of inflammation with an NSAID, the addition of diclofenac or newer more selective analgesic seem to be preferable to ibuprofen.

The Lancet February 2003; 361(9357)

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