What are NSAIDs?

The acronym stands for Nonsteroidal anti-inflammatory drugs. Millions of Americans take them as over-the-counter drugs or in prescription form to relieve pain or to reduce fever or inflammation. They are used for everything from headaches and back pain to arthritis and osteoporosis. The products always display NSAID on their labels. Common brands include Advil (ibuprofen); Motrin (ibuprofen); Aleve (naproxen)

How do NSAIDs work?

NSAIDs work to block enzymes called COX-1 and COX-2 that are responsible for manufacturing substances called postglandins, chemical messengers that can cause inflammation, pain and fever. These postglandins, however, also help regulate blood clotting, protect the lining of the stomach and intestine and help with kidney function.

Why is there concern?

Studies estimate that a person’s relative risk of heart attack and stroke increases 10 percent to 50 percent when they regularly take an NSAID, depending on the particular drug and the dose being used, according to the Food and Drug Administration. Side effects affecting the kidneys, heart or the stomach also can occur when NSAIDs are taken at too high a dose, for too long, or in combination with another NSAID.

In light of the stronger warnings, what should consumers do?

Be sure to read labels to know what you are taking, how to take it and any side effects. Sometimes medicines for multiple symptoms, such as cold medicines, also contain NSAIDs. The American Heart Association recommends taking the lowest effective dose for the shortest period of time required for relief. Over-the-counter NSAID labels say if you take them for more than 10 days to see a doctor.

Take charge of your health, and evaluate the risks and benefits of NSAIDs with your doctor. Have a conversation about your medical history, including any history of cardiovascular disease, and ask your doctor about drug interactions and side effects.

How do I minimize my risk?

You can begin by knowing and lowering your risk factors for heart disease and stroke, which are among the top five causes of death in the United States. Smoking cessation, controlling high blood pressure, maintaining a healthy weight and diet and taking part in daily exercise help reduce your risk.

Stop taking NSAIDs and seek medical help if you experience symptoms that might signal heart problems or stroke, such as chest pain, trouble breathing, sudden weakness in one part or side of the body, or sudden slurred speech.

What about the role of aspirin?

Aspirin also is considered an NSAID but is not included in the warnings. Low-dose aspirin has been shown in clinical trials to reduce the risks of cardiovascular events in patients who have cardiovascular disease or who have already had a heart attack or stroke. Aspirin is sold in generic forms and under brands such as Bayer and St. Joseph’s.