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  1. #1
    Moderator Arthur Little's Avatar
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    Lightbulb 'Heart Attack Risk' For Common Painkillers?

    www.bbc.co.uk/news/health-39858179 ...

    ... next thing, they'll be saying it's a risk to even breathe!


  2. #2
    Trusted Member grahamw48's Avatar
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    Exactly Arthur. Unfortunately 'Wolf' is cried too many times.

    I do my best to live a healthy lifestyle. All things in moderation. Can't do much more.

    The stress of worrying about all this stuff is probably more likely to do you in.


  3. #3
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    It’s already been accepted that these types of painkillers may increase the risk of heart attacks.

    This new study is reported as claiming they may increase the risk by up to 100%.


    It uses statistical terms which may well be misunderstood by health reporters, patients, and even doctors .


    " Meta-analysis " combines results from a number of studies. " Bayesian " takes into account previous information. " Odds ratio " and " relative risk " of greater than 1 means increased risk from whatever factor is being studied.


    This was an " observational study " - they couldn’t prove cause and effect. It was also on patients who had prescribed, not " over-the-counter ", painkillers.


    It's vital to know the " absolute risk " - the probability that an event ( heart attack ) will happen. This new study didn’t make clear this baseline risk of people having heart attacks.


    The absolute risk of any one of us having a heart attack varies - from around nil in a young female to perhaps 5% in an older man. It depends on well known risk factors, some of which can’t be changed ( age, gender, race, family history ) ; whereas others can possibly be modified ( such as cholesterol level, smoking, diabetes, obesity, high blood pressure ). When asked, the authors of this paper said " … it seems reasonable to conclude that the absolute risk due to NSAIDS is on average increased by about 0.5-1% per year ".


    These drugs can be effective, although they should be used in moderation ( in some cases not at all ); other drugs may be available; and continuous pain / inflammation needs treatment if it is not itself to cause more illness.


    The reporting of this topic in the media - as with other health topics - could have been better. As always, moderation in all things and taking advice if needed from a doctor you can trust seems the sensible way forward .


  4. #4
    Respected Member Michael Parnham's Avatar
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    Quote Originally Posted by Doc Alan View Post
    It’s already been accepted that these types of painkillers may increase the risk of heart attacks.

    This new study is reported as claiming they may increase the risk by up to 100%.


    It uses statistical terms which may well be misunderstood by health reporters, patients, and even doctors .


    " Meta-analysis " combines results from a number of studies. " Bayesian " takes into account previous information. " Odds ratio " and " relative risk " of greater than 1 means increased risk from whatever factor is being studied.


    This was an " observational study " - they couldn’t prove cause and effect. It was also on patients who had prescribed, not " over-the-counter ", painkillers.


    It's vital to know the " absolute risk " - the probability that an event ( heart attack ) will happen. This new study didn’t make clear this baseline risk of people having heart attacks.


    The absolute risk of any one of us having a heart attack varies - from around nil in a young female to perhaps 5% in an older man. It depends on well known risk factors, some of which can’t be changed ( age, gender, race, family history ) ; whereas others can possibly be modified ( such as cholesterol level, smoking, diabetes, obesity, high blood pressure ). When asked, the authors of this paper said " … it seems reasonable to conclude that the absolute risk due to NSAIDS is on average increased by about 0.5-1% per year ".


    These drugs can be effective, although they should be used in moderation ( in some cases not at all ); other drugs may be available; and continuous pain / inflammation needs treatment if it is not itself to cause more illness.


    The reporting of this topic in the media - as with other health topics - could have been better. As always, moderation in all things and taking advice if needed from a doctor you can trust seems the sensible way forward .
    Another interesting post, thank you Alan, haven't used any pain killers since 2001 and that was only one on that occasion, it was prescribed to me just after a skin Cancer operation which was a great success!


  5. #5
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    Thank you for reading and responding to my post, Michael - interesting to know that you have not used pain killers for so many years .


  6. #6
    Respected Member Michael Parnham's Avatar
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    Quote Originally Posted by Doc Alan View Post
    Thank you for reading and responding to my post, Michael - interesting to know that you have not used pain killers for so many years .
    You know Alan, I've had very little pain in my life apart from the odd minor thing, but I have never in my life ever experienced a headache


  7. #7
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    All of us do suffer pain at some time or other. Acute pain, which is sudden in onset, and typically short-lived, may have a " biological " or protective function ( such as withdrawal from a hot surface ). Chronic pain may be very long-lasting, as in arthritis or a reaction to cancer.



    Medication for pain depends on its type and severity ( see link ). ALL painkillers have potential side effects, so it’s a balance between advantages and disadvantages of taking them. They may be available " over-the-counter " or require prescription. Of course some may be obtained illegally, not necessarily taken in safe amounts or to relieve pain, perhaps with serious consequences ( opioid / morphine-like drug overdoses, car crashes, and killing by guns may EACH account for about a third of 100,000 deaths a year in USA ).



    People’s attitudes to risks naturally vary. We know the main cardiovascular risk factors, not all of which can be changed. But any calculation of risk is only as good as the evidence it’s based on. The idea with meta-analysis is that by making studies larger by combining data, this reduces chance in the results. There are several " risk calculators " for heart disease - with NO consensus as to which is best.



    The difference between relative and absolute risk may apply not only to risk of a heart attack, but also other conditions and treatments :-








    What is misleading in the media reporting ( or even original writing ) of the " NSAIDs and heart attacks " study is that an increase in RELATIVE risk appears more alarming than ABSOLUTE risk. Similarly " treatment breakthroughs " or " increase in cancers " may appear more dramatic when reported as RELATIVE changes.


    Doctors must keep up to date and clearly inform their patients - hopefully in retirement I’ve explained this topic to interested members !


  8. #8
    Respected Member Michael Parnham's Avatar
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    Very interesting read Alan.


  9. #9
    Trusted Member stevewool's Avatar
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    Quote Originally Posted by Michael Parnham View Post
    You know Alan, I've had very little pain in my life apart from the odd minor thing, but I have never in my life ever experienced a headache
    I have.


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