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Ongoing research has repeatedly shown that using non-steroidal anti-inflammatory drugs (NSAIDs) significantly increases the risk of heart attack. Considering this, are medical doctors recommending alternative treatments for inflammation whenever possible?

A new study suggests that the answer to that question may be "no". Researchers discovered that there was a high prevalence of medical doctors prescribing NSAIDs to patients with rheumatoid arthritis and other inflammatory musculoskeletal diseases despite the NSAIDs high risk for ischemic heart disease. The study included a review of medical charts of 108 patients and found that 16% of the arthritis patients were given the heart damaging drugs.

These findings are especially startling given the already elevated risk for cardiovascular disease that is associated with certain forms of arthritis like rheumatoid arthritis.

“I don’t want to be alarmist and say that patients with (inflammatory) diseases shouldn’t be prescribed NSAIDs,” said head researcher Carl Orr, at a press conference in Madrid. “But with the inflammatory arthropathies it would be preferable to use disease-modifying anti-inflammatory drugs before resorting to NSAIDs.”

While it is widely accepted that long-term prescribing of NSAIDs is unsafe, there has been a general attitude that short-term use of the drugs is a risk worth taking for the heart.

However, a recent study found that just one week of using the NSAID diclofenac increased risk of death or recurrent myocardial infarction in patients with previous MI. Ibuprofen was also shown to increase the risk of heart damage in the short-term.

To determine if NSAIDs were still being used, researchers from the Royal College of Surgeons in Ireland observed the prescribing patterns of medical doctors for their patients over a two-month period. The patients ranged in age from 50 to 87, and 36% had documented ischemic heart disease or had risk factors like diabetes or hypertension.

The researches found that diclofenac was prescribed in 56% of patient cases. “This was particularly disconcerting, because the risk of death and recurrent myocardial infarction with this drug becomes evident immediately,” Orr said.

The drug was prescribed for more than a month in 56% of these patients, and for a year or longer in 15% of them. They even found that in about 25% of the cases, NSAIDs were being used to treat noninflammatory conditions such as post-operative pain and fibromyalgia.

The study authors encouraged that new prescribing guidelines be developed for patients with heart disease risks. They highlighted alternative methods of helping patients with either inflammatory or non-inflammatory diseases. Orr concluded, “New guidelines should be introduced that take into account the new evidence for death and recurrent myocardial infarction, even with short-term use of NSAIDs.” Among NSAIDs, diclofenac is likely the most risky choice, and should be avoided whenever possible.

Chiropractic care, including trigger point therapy and other forms of soft tissue work, has also been found to be effective for treating inflammation associated with a variety of diseases, including rheumatoid arthritis. And chiropractic care, unlike NSAIDs, poses no cardiovascular risks. In fact, one recent study from the University of Chicago, shows that the chiropractic adjustment can reduce hypertension in patients by the equivalent of taking two antihypertensive drugs. And the chiropractic lifestyle, which focuses on heart healthy eating habits and exercise, can also benefit the heart.

Dr. Brad Dahlager, a Noblesville, IN chiropractor practicing at Noblesville Family Chiropractic uses traditional chiropractic adjustments, soft tissue manual therapies, nutritional counseling and exercise regimens to reduce pain and restore function for his arthritic patients. He'll work with you and your existing healthcare providers to provide non-invasive, effective management of your arthritic condition.

How much longer will you risk damaging your heart by taking NSAIDs for your arthritic condition? How much longer will you allow the pain of your arthritis to dictate how well you live your life? Why not call a specially trained chiropractor in Noblesville, IN like Dr. Brad Dahlager for help? Keep your heart healthy and schedule your appointment for a check-up to explore your options with Dr. Dahlager at Noblesville Family Chiropractic today.


  • Orr C, et al. New data, new problem: assessing the prevalence of NSAID prescribing in primary care in those with a background of ischemic heart disease or risk factors for IHD. EULAR Annual European Congress of Rheumatology June 2013.
  • Walsh Nancy. NSAID use raises heart risk in arthritis. MedPage Today June 15, 2013.
  • Bakris, G, MD et al. Special chiropractic adjustment lowers blood pressure among hypertensive patients with misaligned C-1 vertebra. Journal of Human Hypertension, March 2007.