Thursday, April 10, 2014

Painkillers linked to higher risk of stroke: Alert over prescription medicines used by millions

I am afraid that this is just another correlational study which takes no account of WHY some people were on NSAIDS and some were not.  It could be the pre-existing conditions of the NSAIDS takers that led to the vascular problems.  When will they ever learn?

Painkillers used by millions of Britons have been linked to higher risk of irregular heartbeat that could trigger a stroke.  The extra chance of developing atrial fibrillation is as high as 84 per cent, Dutch researchers say.

The condition – a leading cause of first-time strokes – means the upper chambers of the heart are out of rhythm and beat much faster than normal, which allows blood to pool and clot.

At least seven million Britons with arthritis take prescription painkillers, including non-steroidal anti-inflammatory drugs (NSAIDs) such as diclofenac and ibuprofen, and newer medication called coxibs.

In the study, the heart health of 8,423 people aged 55 and older was tracked since 1990 in Rotterdam.

Cases of atrial fibrillation were diagnosed using heart tracer recordings, while the details of drugs prescribed were gathered from pharmacies.

The average age of the study participants was 68, and just over half were women, says a report in the online journal BMJ Open.

During the average monitoring period of just under 13 years, 857 participants developed atrial fibrillation. Of these 261 had never used NSAIDs when they were diagnosed, while 554 had used NSAIDs in the past, and 42 were currently taking these drugs.

Current use was associated with a 76 per cent greater risk of atrial fibrillation than for those who had never taken NSAIDs. Age, sex and underlying heart problems were taken into account.

Use of the painkillers within the preceding 30 days was linked to an 84 per cent greater risk of atrial fibrillation. While there was a trend for higher doses to be linked to higher atrial fibrillation risk, the finding was not statistically significant.

It is thought NSAIDs may contribute to heart rhythm problems by increasing blood pressure as a result of fluid retention.

Bruno Stricker, of the Erasmus Medical Centre in Rotterdam, said previous research had thrown up a link between atrial fibrillation and these painkillers.  ‘Our results also suggest that the increased risk occurs shortly after starting treatment and may disappear over time,’ he added.

NSAIDs work by blocking the COX-2 enzyme which reduces pain and inflammation, but is also important in regulating heart function.

There were 17million prescriptions for NSAIDs in the UK in 2010. Ibuprofen can be bought from pharmacists and supermarkets, along with Voltarol tablets containing diclofenac but at far lower doses than on prescription.

Around ten years ago the anti-arthritis drug Vioxx was voluntarily taken off the market because of an increased risk of heart attacks and strokes.

Professor Colin Baigent, of the clinical trial service unit and epidemiological studies unit at Oxford University, said: ‘This study is consistent with previous reports indicating that some NSAIDs increase the risk of atrial fibrillation.

‘Atrial fibrillation is just one of several cardiac hazards associated with NSAIDs, the most important of which is an increased risk of heart attacks.

‘Although NSAIDs are very effective for the treatment of pain, it is important that both risks and benefits are considered carefully before they are prescribed.’

Oxford researchers last year found that high doses of NSAIDs can increase the risk of heart attacks, strokes and heart failure.

Their study confirmed the existence of a ‘small but significant’ extra risk of dying from heart problems after prolonged use.

The research, published in The Lancet medical journal, found naproxen was the safest NSAID.

Researchers looked at the highest doses of painkillers prescribed by doctors, twice the daily amount recommended for headache and other minor ailments.

They said a short course of tablets bought over the counter for a muscle sprain was unlikely to be hazardous.

The study pooled the findings from 639 trials after numerous small trials showed a link between NSAIDs and heart side effects.


Dietary Committee’s Unpalatable Agenda

When the federal Dietary Guidelines Advisory Committee met last month in Washington, most Americans were unaware of the proceedings. But all Americans should know that the committee’s agenda may give them indigestion, as the government increases control over what they eat.

Every five years, the federal departments of Agriculture and Health and Human Services convene the DGAC. The mission is clear: to make sound nutritional recommendations based on the best scientific research. But in recent years, the dietary committee’s activities and recommendations have gone far beyond that, to the point of vegan zealotry.

Food nutrition guidelines have taken a back seat to “sustainability,” “green practices,” “the long-term health of the planet,” and other green dreams. As a result, the committee increasingly pushes for all Americans to seek locally sourced, organic, plant-based diets.

The committee’s recommendations are used to calculate food allowances for the U.S. military, the food stamp program, the Women Infants and Children program, and the national school lunch program. This will reduce food options for millions of low-income families and students.

The committee agenda also will negatively affect farmers, ranchers, food processors, grocers and many others. Higher food prices will result, causing further hardship to those struggling. Reform is clearly in order.

The committee’s current agenda is driven by leaders such as Kate Clancy of the Minnesota Institute for Sustainable Agriculture. In a recent committee presentation, Clancy advocated vegetarianism in order to achieve sustainability in the face of climate change. Clancy’s proposal drew rave reviews from committee member Miriam Nelson, nutrition professor at Tufts University and founder of the Strong Women Initiative, which seeks “social change by empowering women to be agents of change in the area of nutrition, physical activity and obesity prevention.”

The committee needs to stick to its mandate of providing nutritional and dietary information and guidelines for the general public. Moreover, such open advocacy needs to be balanced with more-practical considerations, especially from those with actual experience growing and producing food.

The guidelines should be based on the best available scientific and medical knowledge currently available. They should not be based on questionable studies and biased information carefully cherry-picked by the committee to support preconceived views.

The guidelines also should be thoroughly evaluated and streamlined—taking into account not only nutritional and health considerations, but food cost and consumer choice as well. Regional diversity also should be respected, not ignored. That means: hush puppies, black-eyed peas and sweet-potato pies are not to be scoffed at, just because our urbane know-it-alls in Washington don’t approve of such foods.

Like most of the federal bureaucracy, the committee lacks accountability and transparency. Reform can start by opening its subcommittee meetings to the public and broadcasting them online. Likewise, all research cited by the committee should be made public from day one, and not kept under lock and key until the committee has submitted its final report.

These common-sense reforms are long overdue but may not be enough to control the committee’s agenda. Meanwhile, taxpayers and legislators should be asking some hard questions.

The federal government is hardly the sole source of nutrition information. In the Internet age, such information abounds from multiple sources. Do Americans really need the committee to tell them that a high-fat, high-sodium diet is bad; that a balanced diet is good, and too many calories on a daily basis can lead to problems? Do we really need Washington to dictate what we eat?

Elimination of the committee is probably asking too much of an administration that adds new federal bureaus and entitlements, even in a recession. But a future administration might consider putting the committee on a starvation diet.


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