COMMON painkillers such as ibuprofen can double the risk of a heart attack if taken at the highest recommended levels, research suggests.
Analysis of all trials revealing a vascular event linked to use of painkillers has shown that high doses of two non-steroidal anti-inflammatory drugs (NSAIDs), ibuprofen and diclofenac, could cause attacks.
The drugs have been previously identified as increasing the risk of heart attacks but experts say this is the biggest and most definitive study yet.
The study does not examine low-dose over-the-counter painkillers, but rather high-dose prescription products.
Vioxx, which is part of a group of anti-inflammatories known as COX-2 inhibitors, was banned in 2004 after it was shown that patients using it were more than twice as likely to have heart attacks.
The latest study confirmed that COX-2 inhibitors doubled the risk but found that NSAIDs did, too.
When all "vascular events" - heart attacks, stroke or vascular disease - were taken together, the drugs increased the risk by 40 per cent.
Researchers from the universities of Oxford and Rome carried out the study, which was published in the British Medical Journal.
They examined the results of all trials in which vascular events had been recorded for COX-2 inhibitors and NSAIDs.
By combining the results they were able to estimate the effects of these drugs more reliably than any individual trial.
They found there were three more heart attacks per 1000 people every year in those who did not already have heart disease but who were taking one of the two types of painkillers.
NSAIDs relieve pain by blocking the action of enzymes called cyclooxygenases (COX), which control inflammatory responses. Although they are effective, the drugs can cause ulcers and dangerous stomach bleeding. COX-2 inhibitors were designed as a safer, long-term alternative to NSAIDs.
Senior researchers said yesterday that the findings showed the urgent need for further clinical studies to identify whether some drugs carried a lower risk than others.
Colin Baigent, who directed the research for Britain's Medical Research Council, said the analysis was carried out over several years and involved 140,000 patients.
"It supersedes all the previous work that has been done in this area," Dr Baigent said.
"Until now, doctors have been very confused. We have looked at all the evidence that has ever been done and our report is hopefully going to help doctors assess these drugs."
He said that people should not panic at the findings as the heart attack rate was small and related only to high-dose patients - those who took "about twice what the normal person would take". Some patients are on high doses with their doctor's approval.
Aspirin, one of the most commonly used painkillers which is sometimes grouped with NSAIDs, was not included in the analysis.
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