ECG of A-Fib

Every day millions of people swallow pain relievers such as ibuprofen (Advil, Motrin, etc), naproxen (Aleve, Naprosyn, etc) or prescription medications such as celecoxib (Celebrex), diclofenac (Cataflam, Voltaren) or meloxicam (Mobic). The National Ambulatory Care Survey showed that 95% of people queried reported that they used NSAIDs. Most know that stomach upset is a potential risk, but many are unaware of the potentially deadly heart problems such drugs may cause.

The latest research published in BMJ Open (online, April 8) revealed that using NSAIDs increases the risk of a heart rhythm disturbance called atrial fibrillation (Afib). This can lead to blood clots that travel to the brain and cause a stroke. In this study of more than 8,000 Dutch people followed for roughly 13 years, those taking an NSAID had an 80% higher risk of developing Afib than those not taking such a pain reliever.

People with Afib are often prescribed anticoagulants to prevent blood clots. These drugs are tricky to manage and have serious side effects of their own. Dangerous bleeding episodes brought on by such medications can be life threatening.

The Dutch researchers did not prove a cause and effect relationship, but this isn’t the first time NSAIDs have been linked to cardiac arrhythmias. Other studies have shown an association between NSAIDs and cardiovascular complications, such as heart attacks.

For the most part the FDA, health professionals and even patients have ignored the risks. When someone dies from a heart attack or stroke, it is unlikely that anyone checks for a drug like ibuprofen or connects the tragedy with pain reliever use.

According to the senior author of the Dutch study, Dr. Bruno H. Stricker,

“I would really strongly advise that older people be very careful with using these drugs. They don’t do anything except relieve pain. Pain is a nuisance, but dying is a nuisance, too.”

Many people use NSAIDs because they don’t know about other ways to alleviate pain. For some ideas, you may wish to consult our Guide to Alternatives for Arthritis.

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  1. Brooke
    Houston TX

    In April 2016, I had upper cancerous lung lobe removed, which was incredibly painful and morphine was not helping, so surgeon’s PA switched me off morphine onto 400 mg ibuprofen EVERY FOUR HOURS – so 2400 mg ibuprofen daily.

    While still in ICU, they also called in cardiologist as they said I had atrial fibrillation (no previous heart problems) and they put me on flecainide, 10 mg eliquis and metoprolol. When I was discharged, my orders signed by two people continued for all that. Not until I had been doing this for two weeks, did I read the Eliquis warnings to not take ibuprofen with eliquis, so immediately stopped ibuprofen.

    When I returned to cardiologist, the doctor found high blood pressure so put me on Losartin as well. I was almost too dizzy to walk! On next cardiology visit I inquired about ablation, was told ablation was not for seniors, and Losartin was doubled.

    THANKFULLY, I was then invited to an ablation mini-maze seminar by a surgeon who has done ablation on people older than I. I went to him, he said the afib would not be needed as it would go away after I healed from lung surgery, took me off flecainide, referred me to a cardiologist who took me off eliquis, did a one-month heart monitor and found my arrhythmia was NOT afib.

    My oncologist said someone at hospital should have caught that. My new cardiologist said it was a wonder my stomach didn’t blow out. My (previous) colo-rectal surgeon said I should go talk to CEO of hospital to make sure communications didn’t need tweaking. For three months now, I’ve tried to get to talk to him – his secretary took my story to him and now neither of them will return my emails. SCARY.

  2. zqicvs

    Lately, I have been reading about Acety -L- Carnitine and R-Lipoic Acid as treatment for diabetic and non diabetic peripheral neuropathy. Has anyone suffering from idiopathic peripheral neuropathy ever tried Acety- L-Carnitine and or R-Lipoic Acid and if so was there relief from the symptoms of the neuropathy ?
    People’s Pharmacy response: Another supplement to try for this problem is benfotiamine:

  3. Cindy M. B.

    A couple of years ago I was dx’ed with Afib and put on a blood thinner (Warfarin) and a beta blocker (Sotolol). That combo really saps one’s strength and vitality. I did lots of research as to WHY I’d gotten the Afib and every single resource did list NSAIDS as a major risk factor. I had, in fact, taken NSAIDS (Aleve) fairly often but not every day and never more than 1 or 2 pills total in a day. Of course I IMMEDIATELY stopped and haven’t taken an NSAID since. Still, most of those studies do refer to “Rx NSAIDS” or a high daily dosage of OTC NSAIDS. I wonder if my small intermittent use of NSAIDS really contributed to the Afib? Fortunately it’s a moot point now because I got an ablation that cured the Afib. I sure hope it never returns!!

  4. fbl

    JTB, look at my list of blood thinners above. I did forget one though. I also take cayenne in a capsule 2X a day.
    Since I started the natural regimen I have had no clotting problems, even when the Afib was really bad. Fortunately the ablation took care of the Afib. I have a bad Mitral valve from the diet drug Fen-pfen I took about 20 years ago so I still need the natural blood thinners to keep from kicking up clots.

  5. paulbyr

    Seems to me that some of us think the Dutch Dr. is the nuisance!

  6. fbl

    CM, I had a serious fall down 26 steps over 20 years go. I had bone spurs so bad in my neck that any change in position gave me stabbing pains. Unfortunately pain meds don’t work on me.
    What finally happened was a Dr. referred me to a Pettibon Chiropractor in 2002 and I was driving again w/in six weeks. My head pain went, the bone spurs went and the X-ray of my neck now is totally amazing. No herniatied disc, no bone spurs and the curvature is back in my neck.
    Getting rid of the pain was the best part of the new therapy and well worth my daily PT.

  7. DS

    My doctor told me to take (9) 200mg of Ibuprofen daily which helps with stiffness. However, I don’t take 9 everyday. Some days 6, 3 or none. In lieu of what you have said, should I continue? I am 72 years old.

  8. JF

    Interesting article, but basically anecdotal, because it’s missing the following essential information: What was the typical usage (frequency and dosage) of the 8000 subjects? How many (and what strength) tablets per day? per week?

  9. Liz

    I have been taking the a baby aspirin daily for years to protect my heart. This is was openly advised many times in the past for healthy people. I recently was diagnosed with nonvalvular Afib. I am wondering if this habit brought it on. Now on blood thinner and heartbeat regulator meds… an use of nsaids strongly prohibited.

  10. BLW

    Naproxen (Aleve) gives me 10 hours of irregular heart beats. Seldom take any NSAIDs.

  11. JTB

    In 2007 I was diagnosed with afib, and have been taking Rx blood thinners plus NSAIDs. After being diagnosed with gastritis the Rx blood thinners (three) were stopped and the NSAID dosage increased from 81 mg to 325 mg daily. I don’t understand the Dutch conclusion that NSAIDs contribute to the risk of afib and heart attack. NAISDs thin the blood and reduce the risk of a blood clot forming and moving to the lungs, heart or brain. Could a medical professional please explain what appears to be contradictory medical practice.

  12. plm

    What about using Voltaren Gel for pain. Is this as bad as the pills? I also use Bayer Aspirin, 2 four times a day.

  13. PB

    I too would love to know if aspirin has the same heightened risks of cardiovascular problems of any kind. Also, whether buffered aspirin, as in Bufferin, is less likely to cause stomach or other bleeding.

  14. Cox

    I don’t believe the Dutch Doctor has RA. He might have a different view.

  15. Soozi

    What about the claims that taking aspirin daily can stop deadly cancers? Inflamation that occurs with ovulation is linked to ovarian cancer, which is hard to diagnose and sometimes very fast moving, claiming lives. Aspirin is said to reduce the chances of getting numerous other cancers as well. Should we take two low dose aspirin every day in consideration of the potential for cancers?
    What if you have a tendency toward cancers, see a genetic counselor and determine you have a high risk of cancer. Should you be taking aspirin.
    The trade off for those at risk for stroke is a fib ? Confusing…

  16. CM

    I have arthritis and bone spurs. It is painful and makes staying at work hard. I am too young to retire. Naproxen, oxprozin, and Tylenol help me through the day and to get to sleep. I have stronger meds to use when my pain level is very high.
    I am concerned about the risk of taking these meds even though they do help. The pain is definitely life-changing for me.
    Grape juice and pectin, gin-soaked raisins, chondroitin, and others have given me little relief. My doctors know what I take and I get frequent check ups with blood work. Hopefully with monitoring and careful use of these drugs, I will not develop Afib or other heart problems.

  17. jp

    The Dutch doctor loftily states that “pain is a nuisance”. Sometimes, maybe. But pain can also be debilitating, life-changing, and can prevent living a normal life, having relationships, being socially active, etc. For this reason, many choose NSAIDs when necessary. Amen.

  18. fbl

    No, when the Drs. get to the end of thier list they finally push me to take aspirin-which I refuse. My gut does NOT like the stuff.
    Pain meds DO NOT work on me, nor do blood pressure meds or blood thinners. I’ve had some pretty awful side effects from them all. This drives most Drs. crazy and they push the meds anyway.
    My latest go-round was after a broken leg and insertion of screws and a titanium rod. Not fun.
    What I have found that helps for the pain is curcurmin. No it doesn’t take the pain away but lowers the level enough that I can live with the pain. Morphine, Oxycodine and the newest one Delautid do NOT work on me.
    For blood thinning I use a combination of nattokinase, serraptase, gingko biloba, Omega 3 and vitamin E. My current cardiologist is very happy with the results and said keep doing what I’m doing.

  19. David B.

    Do you recommend or sell essential oils to be taken instead of NSAIDS?

  20. TKB

    Is aspirin included in this group of NSAIDs causing atrial fib?

  21. paulbyr

    I posed a problem for my doctor – I said “My knee hurts and I cannot take my dog for our 20 to 30 minute walk every morning. Therefore, I am not getting my enjoyable exercise and probably won’t get other exercise as regularly.”
    She pondered this and prescribed that I take 15mg of Mobic (an NSAID) each day for a month. At the end of the month I reported total sucesss with pain. Then, she instructed me to break the pills in half (to 7 1/2 mg each) and take a half pill every other day. I reported back in a month that my knee pain was still gone, unless I tried skipping a pill for 4 days, when the pain started coming back. She said “Fine, take the 7 1/2 mg every other day or even every third day, as required to control the pain.
    That was 2 (or 3) years ago and I still seem to be ok. (crossed fingers)

  22. zqicvs

    I use VOTAREN FORTE GEL twice a day for knee pain and I find it does give me relief. After reading this article, I’m concerned and I would like to know if rubbing VOLTAREN GEL on the knee carries the same health risks as swallowing VOLTAREN capsules /pills.

  23. ME

    I was an otherwise extremely healthy woman when I suffered a mild stroke at age 53. I had been on a hiking trip and was taking ibuprofen several times a day for hiking related muscle stiffness. Doctors have never been able to find the cause of the stroke despite numerous follow-up tests – my arteries are clear, etc. Looking back, I recall several times in the weeks before the stroke an occasional heart “flutter” – kind of like my heart had an off beat. I can’t help but wonder if this wasn’t afib and the cause of my stroke. I posed the use of ibuprofen to my neurologist when I discovered a study that had similar conclusions, and he of course poo-poo’d it.

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