Painkillers can cause stroke via irregular heart rhythm. Non selective non–steroidal anti–inflammatory drugs (NSAIDs) and new generation selective COX–2 inhibitors commonly used to treat inflammation are now linked to an increased risk of irregular heart rhythm called atrial fibrillation (AF), as per a Danish research of 32602 patients led by Professor Henrik Toft Sørensen at Aarhus University Hospital in Denmark.

These drugs are already linked to increased risk of heart attacks and strokes. And now through AF, the risk gets intensified for stroke and new risk added of heart failure and death.

In the study compared with non users, new users (first drug within 60 days of diagnosis) showed 40% increased risk of AF with non–selective NSAIDS and 70% increased risk with COX–2 inhibitors. This means four extra cases of AF per year per 1000 new users of non–selective NSAIDS and seven extra cases of AF per 1000 new users of COX–2 inhibitors.

The risk was highest in the elderly, patients with chronic kidney disease or rheumatoid arthritis especially on COX–2 inhibitors. NSAIDs should be used very cautiously in older patients with a history of hypertension or heart failure.

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