The findings, published in July in the American Journal of Medicine, suggest that doctors should weigh the dangers of these medications carefully, says Anthony Bavry, M.D., the cardiologist who led the study. He recommends acetaminophen (such as Tylenol) to his patients, because it may have a much lower risk of heart complications than other NSAIDs. "Many patients change after they understand the risk from these agents," he says.
These studies mainly looked at older patients with signs of heart disease, but the risk extends to older people generally, says Antman, who is also an editor at Circulation.
Still, this very real risk isn't registering with many patients. "Just because something is available over the counter doesn't mean its use is free of any risk," he says.
People often start taking these medications seeking pain relief for a temporary problem. "The patient feels better and they make the assumption that they need to continue taking this medication," Antman said. "It's a very important cycle to interrupt."
Doctors who cannot find another way to control their patients' pain symptoms should proceed with caution, said Antman, who made that point in a 2007 Circulation scientific statement. "The key message is take the NSAID that is associated with the lowest risk, in the smallest dose for the shortest time necessary to relieve the pain."
Michael Haederle is a freelance writer whose work has appeared in People, the New York Times and the Los Angeles Times.