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Pain Medication and Heart Failure

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Popular anti-inflammatory, pain-killing drugs (called NSAIDs-or non-steroidal anti-inflammatory drugs) may increase the risk of relapse in patients with heart failure according to a study published in the Archives of Internal Medicine (February 11, 2002;162:265-270). NSAIDs, a group of drugs that includes aspirin and ibuprofen, are often used to treat pain and inflammation.

The drugs will not create congestive heart failure (also called CHF), but there may be an association between the use of the drugs and relapse in patients already diagnosed with CHF. CHF occurs when the heart loses the ability to pump efficiently, creating fluid build-up in the body, including the lungs.

Aspirin is often taken to reduce the risk of heart attack, but some research has suggested that those who take other pain medications may increase their risk of heart failure. Researchers found that patients who had filled at least one NSAID prescription were nearly 10 times more likely than those who didn’t use the drugs to have a relapse of CHF.

For certain patients, NSAIDs may indeed cause fluid retention and high blood pressure. Patients who have had angina, congestive heart failure, bypass surgery, heart attack, or angioplasty with stent placement should seriously consider safer alternatives.

Medication vs Natural Health Care for Pain

This month we are sharing some of the research about pain and the use of natural health care. A common misconception that many patients have about treating pain is that the drugs they are taking are actually doing some good. Pain medication does not heal or repair a problem-it only offers temporary relief. That relief comes at a price. Pain medication causes problems.

Arthritis patients take NSAIDs regularly without realizing that they actually interfere with cartilage repair. These drugs are linked to high blood pressure, kidney failure, heart failure, ulceration of the GI tract, and some drugs even interfere with bone repair.

According to research appearing in the American Journal of Medicine, “Conservative calculations estimate that approximately 107,000 patients are hospitalized annually for nonsteroidal anti-inflammatory drug (NSAID)-related gastrointestinal (GI) complications and at least 16,500 NSAID-related deaths occur each year among arthritis patients alone. The figures for all NSAID users would be overwhelming, yet the scope of this problem is generally under appreciated”

The drugs have side-effects and some would even say that they are dangerous, but what are we to do? Many people have pain, and relief is a priority for them. Chronic pain is the most costly health problem in America, with an estimated annual cost of about $90 billion per year. This cost includes lost productivity, legal costs, doctors’ visits and medication; 80% of all visits to the doctor are pain related. An estimated 40 million Americans have arthritis or other rheumatic condition. That number is expected to climb to 59.4 million, or 18.2% of the population, by the year 2020, according to a new report published as a collaborative effort between the National Institutes of Health (NIH), the Centers for Disease Control and Prevention (CDC), the Arthritis Foundation, and the American College of Rheumatology. Approximately 12% of all Americans suffer from migraine headaches. Nine out of 10 migraine sufferers report they can’t “function normally” during days in which a migraine strikes. Three out of 10 migraine sufferers require bed rest when suffering from a migraine.

In 2001, over 13 million people saw a physician for the treatment of back pain. According to the NIH, 65 to 80% of all people have back pain at some time in their life. Half of all working Americans admit to having back pain symptoms each year. Back pain costs an estimated $50 billion each year.
We try not to get too political in this newsletter, but I can’t imagine that speaking in favor of the First Amendment is very controversial. There is a product made from a patented extract of skullcap that would have been worth mentioning in this article. The manufacturer is worried about any claims being made about the product-because it may cause problems with the FDA.

It has outperformed COX-2 inhibitors in clinical studies, but the manufacturer can’t compare the product head-to-head with drugs. It has improved WOMAC scores on arthritis patients, but the manufacturer can’t say that the product treats joint pain. They can say that the WOMAC score is improved, but can’t say what WOMAC is-because it contains the word “arthritis” (it is a pain-rating scale).

In the mean time, products that are linked to high blood pressure, kidney failure, heart failure and death can make claims. Maybe the reason so many older Americans take so many drugs is because they start young-with pain medication (that help to destroy joints-making sure that they continue to need them) and safe alternative products are not allowed to make claims.


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