Calls for ibuprofen sale restrictions after study finds cardiac arrest risk

There have been fresh calls for restrictions on the sale of the painkiller ibuprofen after another study found it heightens the risk of cardiac arrest.

Taking the over-the-counter drug was associated with a 31% increased risk, researchers in Denmark found.

Other medicines from the same group of painkillers, known as non-steroidal anti-inflammatory drugs (NSAIDs), presented an even higher risk, according to the findings published on Wednesday in the European Heart Journal.

Diclofenac, available over the counter in the UK until 2015 and still taken on prescription, raised the risk by 50%.

Prof Gunnar Gislason of the University of Copenhagen, who led the study, called for tighter controls on the sale of ibuprofen and other NSAIDs. He said: “Allowing these drugs to be purchased without a prescription, and without any advice or restrictions, sends a message to the public that they must be safe.

“The findings are a stark reminder that NSAIDs are not harmless. Diclofenac and ibuprofen, both commonly used drugs, were associated with significantly increased risk of cardiac arrest.”

The findings are the latest to raise alarm about the use of NSAIDs. Last September a study in British Medical Journal found they were linked to an increased risk of heart failure. Previous studies have linked the drugs to abnormal heart rhythm – which can cause heart failure – and an increased risk of heart attack and stroke if taken regularly.

Gislason urged people with heart problems to avoid ibuprofen and other NSAIDs. “NSAIDs should be used with caution and for a valid indication. They should probably be avoided in patients with cardiovascular disease or many cardiovascular risk factors,” he said.

“I don’t think these drugs should be sold in supermarkets or petrol stations where there is no professional advice on how to use them.”

Gislason suggested they should only be taken after consulting a doctor. “Over-the-counter NSAIDs should only be available at pharmacies, in limited quantities and in low doses,” he said.

He added: “The current message being sent to the public about NSAIDs is wrong. If you can buy these drugs in a convenience store then you probably think: ‘They must be safe for me.’

“Our study adds to the evidence about the adverse cardiovascular effects of NSAIDs and confirms that they should be taken seriously and used only after consulting a healthcare professional.”

The Danish investigators studied data on almost 29,000 patients who suffered an out-of-hospital cardiac arrest recorded in Denmark between 2001 and 2010. They found that use of any NSAID raised the likelihood of cardiac arrest by 31%.

The researchers speculated that the results could be explained by the effect of the drugs on the cardiovascular system, as they influence platelet aggregation and the formation of blood clots. They may also cause arteries to constrict, increase fluid retention and raise blood pressure.

Gislason said people should not take more than 1,200mg of ibuprofen in one day.

The Proprietary Association of Great Britain, the trade body representing manufacturers of over-the-counter medicines said the study had “several limitations,” and insisted that NSAIDs are safe.

John Smith, its chief executive, said: “Information about daily dosage was only based on estimates rather than accurate data and didn’t account for over-the-counter use. Prescribed NSAIDs would normally contain a higher dosage than those medicines available over-the-counter and would typically be used for longer durations.”

He added: “NSAIDs available over-the-counter, such as ibuprofen, are an effective and appropriately safe way to provide short-term pain relief if used in accordance with the clear on-pack instructions and the patient information leaflet inside. NHS Choices recommends NSAIDs to help relieve pain, reduce inflammation, and bring down a temperature.

“It is important for people with a history of heart disease or other long term condition to speak to a pharmacist before taking any over the counter medicine to check for any potential drug interactions or health concerns.”

Calls for ibuprofen sale restrictions after study finds cardiac arrest risk

Garlic and Raw Milk Treat Pneumonia, Asthma, Insomnia, Cough, Arthritis, and Cardiac Problems

Garlic and Raw Milk Treat Pneumonia, Asthma, Insomnia, Cough, Arthritis, and Cardiac Problems

Fabrice Muamba: We"re even now not doing adequate to avoid cardiac deaths

Fabrice Muamba taking part in for Bolton at Tottenham shortly prior to his collapse on 17 March 2012, two years in the past today. Photograph: Richard Heathcote/Getty Photos

Fabrice Muamba has known as for more defibrillators to be manufactured obtainable at football grounds across the country, two many years soon after the former midfielder suffered a significant cardiac arrest at White Hart Lane when his heart stopped beating for 78 minutes.

Muamba, who retired following the incident but made a complete recovery, at the moment operates alongside the Specialist Footballers’ Association to increase awareness of cardiac health and believes elevated numbers of automated external defibrillators (AEDs) – which supply an electric shock to the body to restore a standard heartbeat – will save far more lives.

The Football Association and the British Heart Foundation joined forces last yr to co-fund a campaign generating 900 AEDs offered to football clubs outside the skilled game – from steps one to 6 of the national league system and the Women’s Super League.

The scheme, which price around £4m, has seen 360 clubs signal up so far and the BHF is currently in the procedure of distributing defibrillators to these teams. Even so, Muamba believes far more can be done to avoid potential fatalities.

“My incident occurred at the proper area at the correct time,” mentioned Muamba, who collapsed on the pitch in March 2012 in the course of an FA Cup match amongst Tottenham and Bolton Wanderers. “People were ready to help me rapidly but at decrease league it would have been a entirely various story. It truly is about currently being ready to boost the emergency treatment method in the decrease leagues so if it happens there gamers can have the exact same therapy that I had.

“Entry to defibrillators is crucial and being in a position to train everyone to do CPR (cardiopulmonary resuscitation). That’s what needs to be carried out. A lot of sports folks die from sudden cardiac arrests so I feel it truly is essential to train little ones, train every person involved in football clubs to be in a position to do CPR. Entry to defibrillators is extremely crucial.

“Much more products [is necessary] and to educate children about CPR. Teaching requirements to be accessible to everyone, all over the place. It fees but you just need to have entry to defibrillators.”

Muamba, 25, was provided 15 defibrillator shocks following his collapse on the pitch at Tottenham and ambulance journey to the London Chest Hospital in Bethnal Green right after struggling ventricular fibrillation – fast chaotic electrical activity within the heart.

Twelve people aged 35 and below die each week from sudden cardiac problems according to the charity Cardiac Risk in the Younger, and the head of sports medication at Liverpool, Dr Zafar Iqbal, has campaigned for 18 months in an attempt to secure legislation that would make it mandatory to have defibrillators in colleges and public areas across the country.

Dr Iqbal, who previously worked at Spurs exactly where he set up a amount of emergency protocols, explained: “The Fabrice Muamba incident highlighted the problem but not sufficient was done to increase our investigation in this area in contrast to nations such as America and Norway.

“There they’ve received an out of hospital survival rate of a lot more than 50% for sudden cardiac incidents but here it only ever goes up to 25%, depending on exactly where you are in the nation. AEDs need to be at all sports clubs and all fitness centres. In Italy they have reduced particular kinds of cardiac deaths by a lot more than 90% by doing yearly screening on people who do any sport.”

Muamba additional: “I am just thankful that I had the proper individuals at the right time, who did a excellent work on me. I am really thankful for that.”

Fabrice Muamba: We"re even now not doing adequate to avoid cardiac deaths

Tooth Extraction Prior to Cardiac Surgical treatment May Not Be a Very good Concept

Men and women with an infected or abscessed tooth are at elevated danger for cardiovascular condition. They are at specific threat for building a significant infection in the course of surgical treatment, such as endocarditis, a probably daily life-threatening infection of the heart. Since of this threat, in purchase to lessen the opportunity of infection, several patients undergo dental extraction prior to possessing a planned cardiac surgery. Now, nevertheless, a new paper published in The Annals of Thoracic Surgery raises the probability that prophylactic dental extraction might be far far more risky than previously thought.

Physicians from the Mayo Clinic retrospectively reviewed data from 205 patients who underwent dental extraction prior to a planned cardiac operation. They discovered a greater than expected (8%) fee of adverse outcomes, defined as death, acute coronary syndrome, stroke, renal failure requiring dialysis, and postoperative mechanical ventilation. A complete of three% of the topics died right after the dental extraction and just before the cardiac surgery.

It looks attainable, they wrote, that “preoperative dental surgical procedures may possibly boost danger in these individuals.” But they have been “unable to conclude the adverse outcomes have been due to dental extraction. However, the cumulative insults endured by these individuals during dental extraction (extra anesthetic and surgical stresses), along with delay in definitive cardiovascular operation, could have contributed to the end result.”

“Guidelines from the American University of Cardiology and American Heart Association label dental extraction as a minor process, with the danger of death or non-fatal heart assault estimated to be less than one%,” explained the 1st writer, Mark Smith, in a press release. “Our benefits, even so, documented a larger price of main adverse outcomes, suggesting doctors must assess individualized danger of anesthesia and surgical treatment in this patient population.”

The paper represents “a considerable departure from present thinking,” writes Michael Jonathan Unsworth-White  in an invited commentary. It “raises the query whether or not we ought to in reality get on with our cardiac operations and deal with the dental perform at some other time, if at all, or risk killing our sufferers with very good intent!”

Tooth Extraction Prior to Cardiac Surgical treatment May Not Be a Very good Concept