Painkillers- NSAIDs - the list of side effects grows

Correct me if Im wrong, but we take painkillers to help us dont we?

That is as simple as it should be, but as an HSI member you are probably well aware of the side effects and risks associated with taking nonsteroidal anti-inflammatory drugs (NSAIDs).

Lets take a look at another way these controversial painkillers may cause more harm than good.

Possible link between painkillers and hypertension
US news website ABC recently covered a study published in the American Heart Association (AHA) journal Hypertension. We'll take a quick look at the study and then get back to ABC in a moment.

A team from Brigham and Women's Hospital (BWH) at Harvard University (US) analysed data from the first and second Nurses' Health Studies. Using information from questionnaires, the researchers gathered data on hypertension and painkiller use in more than 5,000 women, ages 51-77 in the first study and ages 34-53 in the second study. None of the women had hypertension at the outset of either study.

Results showed that aspirin intake had no association with the development of hypertension. But other painkillers didn't fare as well:

* Women in the older age group who used an average of 400 mg of ibuprofen per day had an 80 percent increased risk of hypertension compared to women who didn't use ibuprofen.

* Women in the younger group who used 400 mg of ibuprofen per day had a 60 percent increased risk of hypertension

* Women in either group who took an average of 500 mg or more of acetaminophen daily were twice as likely to develop hypertension compared to women who didn't use the drug

In the published study, the authors write: 'Because acetaminophen (paracetamol) and nonsteroidal anti-inflammatory drugs are commonly used, they may contribute to the high prevalence of hypertension in the United States.'

Follow the money
In many e-alerts I've taken studies to task when their designs were obviously flawed or the conclusions clearly biased. And basically that's all ABC did with the BWH study. Or that's how it appears on the surface.

What made caught my attention was this: I've never seen ABC take apart a study and criticise the design. In just the past month we've seen vitamin E and echinacea treated unfairly by flawed research that was widely reported. But in both those cases ABC just got in line with the rest of the mainstream press and reported only the negative results, not the glaring flaws.

So why did ABC pick this study for a grilling? Well, there could be all sorts of reasons. But, hmmm, let's see, the possibility that comes to mind most readily is the fact that the network receives millions of dollars in advertising revenues from the makers of acetaminophen and ibuprofen products.

Just a thought.

Reality...checked
Here's how the ABC piece went. Reporter John McKenzie stated that, 'Many doctors today were unusually critical of this latest research, and they worried about the fear it could trigger.' Well heaven FORBID there should be any fear of these painkillers which have been PROVEN to cause gastrointestinal problems along with kidney and liver damage when taken in excess. But fears about vitamin E, which is safe and has been shown to promote heart health? Hey, no problem there.

But who were these 'many doctors'? And in what context were they voicing their concerns? Did the doctors call a press conference? Or did an industry advocacy group issue a statement? Did the doctors contact ABC? Or did ABC contact the doctors? Mr. McKenzie doesn't say. He just refers to 'many doctors.' And then quotes two.

Here are the flaws in the BWH study, according to the doctor duo:

* Researchers didn't measure the subjects' blood pressure, they relied on subjects to report on any diagnosis of hypertension

* Researchers didn't count the pills subjects were taking - again they relied on the subjects to report painkiller intake

* There was no follow up to see if the amount or type of painkillers taken at the beginning of the study changed by the end of the study

* The study didn't rule out other potential causes of hypertension

These are valid points, although a couple of them are fairly weak. For instance, if a nurse says she's been diagnosed with high blood pressure, well c'mon, she's a NURSE! She would know.

What Mr. McKenzie doesn't note is that the researchers are well aware that their findings are not the last word on the question of a painkiller/hypertension link.

In an AHA press release about the study, lead author, Dr John Phillip Forman, states that more research is needed to confirm the findings, and adds, 'It is important to emphasise that our study is not proof that these drugs will raise blood pressure in all women. Rather, women and their doctors should use caution when using these drugs.'

That seems like a reasonable conclusion: Be cautious. Talk to your doctor.

The ABC report, on the other hand, ends on this note: 'The doctors told ABC News there's no reason for people to change how they're using these pain pills, at least not based on this study.'

So if you're a middle-aged woman who's taking acetaminophen or ibuprofen daily, should you ignore this study and make no change in your painkiller use? Or should you be cautious and talk to your doctor?

One of those suggestions is clearly flawed.