Pain Medication and Heart Failure

Popular anti-inflammatory, pain-killing drugs (calledThe drugs have side-effects and some would
NSAIDs-or non-steroidal anti-inflammatory drugs)even say that they are dangerous, but what are
may increase the risk of relapse in patients withwe to do? Many people have pain, and relief is a
heart failure according to a study published in thepriority for them. Chronic pain is the most costly
Archives of Internal Medicine (February 11,health problem in America, with an estimated
2002;162:265-270). NSAIDs, a group of drugs thatannual cost of about $90 billion per year. This cost
includes aspirin and ibuprofen, are often used toincludes lost productivity, legal costs, doctors' visits
treat pain and inflammation.and medication; 80% of all visits to the doctor are
The drugs will not create congestive heart failurepain related. An estimated 40 million Americans
(also called CHF), but there may be an associationhave arthritis or other rheumatic condition. That
between the use of the drugs and relapse innumber is expected to climb to 59.4 million, or
patients already diagnosed with CHF. CHF occurs18.2% of the population, by the year 2020,
when the heart loses the ability to pumpaccording to a new report published as a
efficiently, creating fluid build-up in the body,collaborative effort between the National
including the lungs.Institutes of Health (NIH), the Centers for Disease
Aspirin is often taken to reduce the risk of heartControl and Prevention (CDC), the Arthritis
attack, but some research has suggested thatFoundation, and the American College of
those who take other pain medications mayRheumatology. Approximately 12% of all
increase their risk of heart failure. ResearchersAmericans suffer from migraine headaches. Nine
found that patients who had filled at least oneout of 10 migraine sufferers report they can't
NSAID prescription were nearly 10 times more"function normally" during days in which a migraine
likely than those who didn't use the drugs to havestrikes. Three out of 10 migraine sufferers require
a relapse of CHF.bed rest when suffering from a migraine.
For certain patients, NSAIDs may indeed causeIn 2001, over 13 million people saw a physician for
fluid retention and high blood pressure. Patientsthe treatment of back pain. According to the NIH,
who have had angina, congestive heart failure,65 to 80% of all people have back pain at some
bypass surgery, heart attack, or angioplasty withtime in their life. Half of all working Americans
stent placement should seriously consider saferadmit to having back pain symptoms each year.
alternatives.Back pain costs an estimated $50 billion each year.
Medication vs Natural Health Care for PainWe try not to get too political in this newsletter,
This month we are sharing some of the researchbut I can't imagine that speaking in favor of the
about pain and the use of natural health care. AFirst Amendment is very controversial. There is a
common misconception that many patients haveproduct made from a patented extract of
about treating pain is that the drugs they areskullcap that would have been worth mentioning in
taking are actually doing some good. Painthis article. The manufacturer is worried about any
medication does not heal or repair a problem-itclaims being made about the product-because it
only offers temporary relief. That relief comes atmay cause problems with the FDA.
a price. Pain medication causes problems.It has outperformed COX-2 inhibitors in clinical
Arthritis patients take NSAIDs regularly withoutstudies, but the manufacturer can't compare the
realizing that they actually interfere with cartilageproduct head-to-head with drugs. It has improved
repair. These drugs are linked to high bloodWOMAC scores on arthritis patients, but the
pressure, kidney failure, heart failure, ulceration ofmanufacturer can't say that the product treats
the GI tract, and some drugs even interfere withjoint pain. They can say that the WOMAC score
bone repair.is improved, but can't say what WOMAC
According to research appearing in the Americanis-because it contains the word "arthritis" (it is a
Journal of Medicine, "Conservative calculationspain-rating scale).
estimate that approximately 107,000 patients areIn the mean time, products that are linked to high
hospitalized annually for nonsteroidalblood pressure, kidney failure, heart failure and
anti-inflammatory drug (NSAID)-relateddeath can make claims. Maybe the reason so
gastrointestinal (GI) complications and at leastmany older Americans take so many drugs is
16,500 NSAID-related deaths occur each yearbecause they start young-with pain medication
among arthritis patients alone. The figures for all(that help to destroy joints-making sure that they
NSAID users would be overwhelming, yet thecontinue to need them) and safe alternative
scope of this problem is generally underproducts are not allowed to make claims.
appreciated"