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Fears are reignited over fluoxetine for children

The safety of NSAIDs has been thrown into doubt once again after an analysis of UK general practice found the drugs raised the risk of hospitalisation for heart failure.

The researchers said their results were particularly worrying for the elderly or those with pre-existing heart failure, and warned the drugs could be having a 'considerable public health impact'.

The study found patients taking low to medium doses of NSAIDs had a 30 per cent increased risk of admission for heart failure, rising to 40 per cent for those on high doses.

'This increased risk, although small, may result in considerable public health impact,' concluded the researchers, from the Spanish Centre for Pharmacoepidemiologic Research in Madrid.

'In patients with prior clinical diagnosis of HF the use of NSAIDs might lead to worsening of pre-existing HF that triggers their hospital admission,' the researchers added.

Dr Gerald Partridge, a GP with a special interest in echocardiography and CHD lead at Airedale and Bradford North PCT, said: 'This is an important study. It makes no sense to keep HF patients on NSAIDs ­ with their adverse renal effects ­ if these can be avoided.

'The possibility of a prothrombotic effect, which might be a second mechanism underlying this result, is another reason to avoid these drugs in HF.'

The research, presented at last week's International Society for Pharmacoepidemiology conference in Nashville, US, used the UK general practice research database to compare 1,396 heart failure admissions and 5,000 matched controls.

By Nerys Hairon

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