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Scientists Spot How Cox-2 Painkillers Raise Heart Risks
Drugs.com ^ | May 2, 2012 | NA

Posted on 05/07/2012 4:08:49 AM PDT by neverdem

New research has uncovered how some cox-2 painkillers increase the risk for both heart attacks and stroke.

The once popular cox-2 drugs, Vioxx and Bextra, were pulled off the market in 2004 and 2005, respectively, after research showed that both raised the chances of cardiovascular trouble. Meanwhile, Celebrex, a painkiller in the same drug class that remains on the market, carries a "black box" warning alerting patients to potential heart risks.

Now, a team of scientists from the University of Pennsylvania in Philadelphia say that, although cox-2 inhibitors are very good at inhibiting the workings of the cox-2 enzyme -- and thereby easing pain -- they also throw off the cardiovascular system's delicate balance by inhibiting an enzyme that relaxes blood vessels and guards against clotting.

"It's really about a rock and a hard place," said Dr. Christopher Cannon, a cardiologist at Brigham and Women's Hospital in Boston. "There's a balance in the bloodstream of clotting and vasoconstriction, as well as protection against clotting and vasodilation, which means that there's a constant balance of clotting and preventing clotting, and constricting arteries and dilating arteries."

"But with cox-2 inhibitors, they have found that you knock the protective side of that balance off," Cannon said. "And then you're left only with the constrictive part, which means the drugs up the risk for clotting and arterial constriction."

"This problem is bigger than just Vioxx, which no longer exists," he added. "It applies to every single NSAID (non-steroidal anti-inflammatory drug), because with all NSAIDs -- including Celebrex and ibuprofen, which zillions of people take -- the same issue exists. You block out the good stuff and leave the bad stuff unchecked. The one exception is Naproxen, which has an anti-platelet effect that seems to work against stroke and heart attack risk."

"Sometimes you have to take a cox-2 because you have really bad daily pain," said Cannon. "But this is a dose-dependent problem, with the more cox-2 you take the greater the cardiovascular risk. So you have to limit the dose and take the least amount you can get away with, so you can try to control crippling pain but also try not to poison your blood vessels and predispose yourself to clotting and high blood pressure."

The latest research was led by Dr. Garret FitzGerald, chairman of Penn's department of pharmacology and director of the Institute for Translational Medicine and Therapeutics. He and his colleagues published their findings in the May 2 issue of the journal Science Translational Medicine and the April 9 online issue of the Proceedings of the National Academy of Sciences.


TOPICS: Culture/Society; News/Current Events; Testing
KEYWORDS: cad; cox2inhibiters; cox2painkillers; cvd; nsaids; painkillers; painrelief
Vascular COX-2 Modulates Blood Pressure and Thrombosis in Mice

Disruption of the 5-lipoxygenase pathway attenuates atherogenesis consequent to COX-2 deletion in mice

1 posted on 05/07/2012 4:09:03 AM PDT by neverdem
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To: neverdem

I thought they’d known this for sometime. I’m down to one 800mg of Ibuprofen a day for osteoarthritis. Back to aspirin and the chance of bleeding ulcers. Nothing is safe.


2 posted on 05/07/2012 4:26:20 AM PDT by poobear
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To: El Gato; Ernest_at_the_Beach; Robert A. Cook, PE; lepton; LadyDoc; jb6; tiamat; PGalt; Dianna; ...
Amish farm kids remarkably immune to allergies: study

Shot may top acupuncture for pain relief: Mouse study finds enzyme injection has lasting effects

Remote-controlled genes trigger insulin production

Salmonella in dog food sickens 14 people in US

"Our folks are really wanting people to be aware of it. They want to be aware that this is causing people to get sick because they may have product in their homes. For every one that is reported, there may be 29 others," Russell said.

--snip--

The recall covers a number of pet food brands made at the Gaston plant, including Canidae, Natural Balance, Apex, Kirkland, Chicken Soup for the Pet Lover's Soul, Country Value, Diamond, Diamond Naturals, Premium Edge, Professional, 4Health and Taste of the Wild.

FReepmail me if you want on or off my health and science ping list.
3 posted on 05/07/2012 4:28:53 AM PDT by neverdem (Xin loi minh oi)
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To: poobear
I thought they’d known this for sometime. I’m down to one 800mg of Ibuprofen a day for osteoarthritis. Back to aspirin and the chance of bleeding ulcers. Nothing is safe.

"The one exception is Naproxen, which has an anti-platelet effect that seems to work against stroke and heart attack risk."

I'd take a baby aspirin and check out Naproxen. Aspirin is supposed to irreversibly inhibit platelet agregation, or so I was taught.

I don't know about Naproxen besides that claim.

4 posted on 05/07/2012 4:50:47 AM PDT by neverdem (Xin loi minh oi)
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To: poobear
Back to aspirin and the chance of bleeding ulcers. Nothing is safe.
I think the chance of getting ulcers from aspirin or ibuprofin are about the same. Taking either one with enteric coating may help decrease that chance.
I've been a runner for 30 years and of all the pain medication I've taken, Naproxen bothered my stomach the worst.
5 posted on 05/07/2012 5:00:36 AM PDT by oh8eleven (RVN '67-'68)
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To: neverdem

I took Naproxen many years ago when it was prescription only. I think it’s OTC Alleve now. It works too.

BTW my arthritic hip turned out to be Stage 4 necrosis. Powder. As soon as they got that nasty thing out last year my blood is back to normal. I’m king of the world! Well, except for the knee thing ;D!


6 posted on 05/07/2012 5:02:26 AM PDT by poobear
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To: poobear
How about aspirin and the chance of bleeding under the retina?

You don't want that either.

7 posted on 05/07/2012 5:02:44 AM PDT by muawiyah
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To: oh8eleven

Darn!


8 posted on 05/07/2012 5:07:21 AM PDT by poobear
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To: All

I got off the ibuprofen with taking fish oil supplements
that also seem to help with inflammation.


9 posted on 05/07/2012 5:12:03 AM PDT by CharlotteVRWC
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To: All

I got off the ibuprofen by taking fish oil supplements
that also seem to help with inflammation.


10 posted on 05/07/2012 5:12:17 AM PDT by CharlotteVRWC
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To: CharlotteVRWC

Borage oil and black currant seed oil are both omega-6 oils that are high in GLA (gamma linolic acid) and do better at lowering cholesterol than fish oil (and dont taste like crap when you belch) and the GLA helps your body naturally control inflamation a thousand times better than fish or even krill oil.


11 posted on 05/07/2012 5:26:30 AM PDT by Delta 21 (Oh Crap !! Did I say that out loud ??!??)
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To: oh8eleven

Enteric coating helps with stomach upset but has not been shown to decrease the risk of ulcers caused by NSAIDS.

I think NSAIDS carry a lower risc of ulceration than high dose aspirin but it has been decades since I’ve seen literature regarding the matter.

That said, I find the same thing, Naproxen upsets my stomach more than aspirin or ibuprofen but it seems to vary by individual, my wife tolerates Naproxen better than ibuprofen.


12 posted on 05/07/2012 6:17:39 AM PDT by dangerdoc (see post #6)
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To: poobear; neverdem

The danger is no worse than before you read the article. And it’s very minimal with one dose of ibuprofen a day. Ibuprofen also has the anti-platelet effect, albeit short-lived and only for a few days, that aspirin (antiplatelet for the life of platelets in circulation when you take it) and naproxyn (a few day’s antiplatelet effect).

The article is a single report on *how* something happens. And, as you thought, it’s an action that we’ve known about for awhile.

I wouldn’t change your routine - in fact, I take Celebrex about once or twice a week.

Talk to your doctor before changing, especially when news like this comes out.


13 posted on 05/07/2012 6:28:51 AM PDT by hocndoc (WingRight.org Have mustard seed, not afraid to use it. Hold Rs to promises, don't watch O keep his.)
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To: neverdem; poobear

***”The one exception is Naproxen...”***

My mom talked her doctor into giving her perscription Naproxin for her arthritis. He warned her he would have to monitor her kidney function real close. She still wanted it.

One dose and it killed her kidneys dead. She died not long after from renal failure.

I will never take Naproxin or anything with it in it.


14 posted on 05/07/2012 7:19:49 AM PDT by Ruy Dias de Bivar
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To: hocndoc

Sounds like good advice. Taming severe pain to moderate is my daily goal.


15 posted on 05/07/2012 7:25:44 AM PDT by poobear
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To: poobear

Use deglycerrized licorice to protect your stomach. You can get it at most health food stores. I used it when I was taking 6 - 325mg aspirin a day for extended time.


16 posted on 05/07/2012 9:08:27 AM PDT by goodnesswins (2012..."We mutually pledge our Lives, our Fortunes, and our Sacred Honor")
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To: dangerdoc

see post 16


17 posted on 05/07/2012 9:15:20 AM PDT by goodnesswins (2012..."We mutually pledge our Lives, our Fortunes, and our Sacred Honor")
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To: dangerdoc
it seems to vary by individual, my wife tolerates Naproxen better than ibuprofen.
Yep. My brother and I were talking about pain killers and he had no problem with Naproxen.
18 posted on 05/07/2012 9:24:19 AM PDT by oh8eleven (RVN '67-'68)
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To: CharlotteVRWC
I got off the ibuprofen with taking fish oil supplements that also seem to help with inflammation.
I think green tea fights inflammation effectively too
19 posted on 05/07/2012 9:26:11 AM PDT by oh8eleven (RVN '67-'68)
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To: goodnesswins

Thanks! Some of the best advice right here at FreeRepublic!


20 posted on 05/07/2012 9:30:48 AM PDT by poobear
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To: goodnesswins

Watch for swelling and elevated blood pressure, licorice has a component that acts like the hormone aldosterone.


21 posted on 05/07/2012 11:00:21 AM PDT by dangerdoc (see post #6)
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To: dangerdoc

NOT deglycerrized....


22 posted on 05/07/2012 12:06:45 PM PDT by goodnesswins (2012..."We mutually pledge our Lives, our Fortunes, and our Sacred Honor")
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To: dangerdoc

http://www.livestrong.com/article/339812-the-side-effects-of-deglycerized-licorice/


23 posted on 05/07/2012 12:08:04 PM PDT by goodnesswins (2012..."We mutually pledge our Lives, our Fortunes, and our Sacred Honor")
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To: poobear

More and more, it’s looking like the good ol’ fashioned pain killers are about the only thing good to take, having the least PHYSICAL side effects. Aside from the chemical dependance, there’s FAR less downside to them(for people that take them responsibly). Of course, the big Pharm companies don’t like the idea of this, because there isn’t much money to be made on that class of medications, because they are so cheaply made and available generic. They would MUCH rather go for big profits and have you take something that will shred your GI tract and or give you a heart attack/stroke than sell something for less profit that actually WORKS.

/rant_off


24 posted on 05/07/2012 4:48:27 PM PDT by KoRn (Department of Homeland Security, Certified - "Right Wing Extremist")
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To: poobear
BTW my arthritic hip turned out to be Stage 4 necrosis. Powder.

Necrosis stings a bit, doesn't it?

25 posted on 05/07/2012 4:59:23 PM PDT by Cyber Liberty (Obama considers the Third World morally superior to the United States.)
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To: Cyber Liberty

Level 10 pain. Nothing can describe it except it’s over!


26 posted on 05/08/2012 3:54:59 AM PDT by poobear
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To: poobear

Thank Goodness for that. Yes, level 10, and painkillers have no effect (Can’t get them *inside* the bone where the pain is). And, as you may have guessed, you don’t have to explain it to me. Mine is gone now as well.

The best way I can describe it is like having somebody slowly break your leg over the period of months.


27 posted on 05/08/2012 5:15:42 AM PDT by Cyber Liberty (Obama considers the Third World morally superior to the United States.)
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To: Cyber Liberty

That’s a fairly good description. Mine, try walking on the broken stump of the femur without a hip ball. I felt like throwing in the towel a couple of times and it would have been quite easy except I had a daughter who was turning 16 at the time. Funny how things like that will keep you hanging on. So glad you are better too!


28 posted on 05/08/2012 5:39:40 AM PDT by poobear
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