Painkillers and stroke risk factors

Stroke and Heart Attack are kindred spirits, cousins you might say. Both represent in the main diseases of the blood vessels. Thus it is no coincidence that the risk factors for heart attack are similar to the the risk factors for stroke.

Several of the relatively new "wonder" anti-inflammatory drugs (Cox-2 inhibitors), such as Vioxx and Bextra, used in the treatment of arthritis have been withdrawn from the market because they have been linked to an increased risk of heart attack. Do they also increase the risk of stroke?

More recent studies have also raised concerns about possible heart risks from some of the older over-the-counter anti-inflammatory drugs including ibuprofen (Motrin and other brand names) and diclofenac (Voltaren), particularly when given by injection. Do they too also represent an increased risk factor for stroke?[2]


Research done at the National Taiwan University Hospital examined the data of 38 000 people who suffered a stroke in 2006. The study found that the use of any Non-steroidal Anti-Inflammatory Drug was associated with a raised CVA risk from 20 to 90% for most oral NSAIDS; and a 260 percent increase for oral Ketorolac.

The absolute risk is quite small.

In people free from the major stroke risk factors such as high blood pressure, pre-existing heart disease and smoking; diabetes and raised cholesterol too. The absolute risk is really quite small.

For example, people in their 50's without these risk factors have only a 1 to 3% chance of having a stroke in the next ten years. Even if this figure was doubled, it would remain relatively low.

However, in high risk patients these other complicating factors for stroke start to become very significant. Have you had a stent fitted or passed out when turning your head? Do you have angina or  had a TIA (Temporary Ischemic Attack)? Has your blood sugar ever been significantly raised; has your doctor ever recommended blood pressure medication, or anticoagulants?

"These latest findings suggest that the concern about NSAIDs and the increased risk of heart attack may also extend to stroke," said Dr Elliott Antman, a professor of medicine at Harvard Medical School.

"Limiting use of NSAIDS is nevertheless a good idea," said Antman, "and especially important for people with established heart disease or its risk factors, such as high blood pressure."

"The bottom line is that even common over the counter medications are real drugs that do have risks. People should not continue to take NSAIDs beyond the period of time recommended on the label without talking with their doctor first."

- Prof Elliott Antman

Cutting the risk of having a stroke

Most of us can handle the thought of pain as we age, but disablement and loss of independence are another matter. Stroke may mean loss of the ability to speak, walk and to write; to care for yourself.

Taking these risk factors for stroke for granted is really not an option. Do you have any of these?

High blood pressure

Whilst Chiropractors in the main encourage their patients to consider alternatives like weight loss and exercise before taking drugs, I think there is almost universal agreement that hypertensive medication is one of the non-negotiables if you have high blood pressure.


Whale trail walking benefits

There is so much overwhelming evidence that people who walk have lower cholesterol, their blood sugar behaves better and their creaking arthritic joints give less pain; they are less depressed. It's just plain relaxing. Are you one of those who do not exercise and have no leisure time hobbies? You are at higher risk of both heart attack and stroke; more backache too.

Walking is a vital part in cutting stroke risk; and getting off those anti-inflammatory drugs that are a significant part of the stroke risk factors associated with painkillers.


The battle is won between the ears. I want to see my grand-kids grow up.

Anti-inflammatory painkillers

Do your level best to avoid them, especially if you are in the high risk category for stroke. Even aspirin increases the risk of anemia by 20%[3].

"We found that low-dose aspirin also increased the risk of anaemia during the trial, and this was most likely due to bleeding that was not clinically apparent."

- Dr Zoe McQuilten, haematologist, Monash University

Painkillers and stroke risk factors weighs research in an eminent medical journal.

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