NSAID use increases CVD risk in osteoarthritis

Non-steroidal anti-inflammatory drug (NSAID) use in patients with osteoarthritis is associated with an increased risk of cardiovascular disease (CVD), according to the results of a recent longitudinal study.

Osteoarthritis (OA) is already recognised as an independent risk factor for increased CVD, yet the underlying mechanism for this associated risk is not completely understood. NSAIDs are often prescribed in the treatment of OA, and it has been hypothesised that they may influence the relationship between the two conditions.

The study, published in Arthritis and Rheumatology, used health administrative data from British Columbia, Canada to select 7743 patients with OA and 23 229 non-OA controls, matched on age and sex. Participants were estimated as to their risk of CVD, ischemic heart disease (IHD), congestive heart failure (CHF) and stroke, while the PharmaNet database was used to define NSAID use in both cohorts.

After adjustment for confounding variables such as hypertension, BMI and diabetes, results showed that patients with OA had a higher risk of developing CVD than the control group, with an adjusted hazard ratio (HR) of 1.23 (confidence interval 95%). When compared with controls, the risk of IHD, CHF and stroke was also higher in OA patients at HR 1.17, 1.42 and 1.14, respectively. NSAID use mediated approximately 41% of the total effect of OA on increased CVD risk.

On their results the study authors said: ‘Findings of this first study to evaluate NSAID’s mediating role in OA-CVD relationship suggest that NSAID use substantially contributes to the OA-CVD association.’

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