Xie Anmin, former director of the Cardiac Intensive Care Unit of Chicago Veterans Hospital, said that there are many types of painkillers, among which NSAID anti-inflammatory painkillers are suitable for the elderly over 80 years old, poorly controlled diabetes, who have not used NSAIDs before, and taking diuretics and inhibitors at the same time. Inhibition of 4 groups such as the renin-angiotensin system may increase the risk of hospitalization for heart failure; the picture shows a situational photo. (picture taken from freepik)
[Health Channel/Comprehensive Report]Painkillers are common medicines at home, but most people don’t know about them. Although they are all painkillers, their effects and side effects vary according to the ingredients. Xie Anmin, former director of the Cardiac Intensive Care Unit of Chicago Veterans Hospital, said that there are many types of painkillers, among which NSAID anti-inflammatory painkillers are suitable for the elderly over 80 years old, poorly controlled diabetes, who have not used NSAIDs before, and taking diuretics and inhibitors at the same time. Inhibition of the renin-angiotensin system and other 4 groups may increase the risk of heart failure and hospitalization, so it is a reminder to use anti-inflammatory analgesics with caution.
Xie Anmin posted on Facebook “Dr. Xie speaksThe article pointed out that painkillers can be divided into 3 categories, such as narcotic drugs, anti-inflammatory painkillers and painkillers. The most popular pain reliever is acetaminophen, which relieves pain and reduces fever, but does not reduce inflammation. Painkillers with anti-inflammatory effects, the most important ones are non-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen (ibuprofen), naproxen (naproxen), diclofenac (diclofenac).
3 ethnic groups use NSAID “drugs” carefully
Xie Anmin said that in addition to narcotic drugs, some anti-inflammatory painkillers and painkillers are over-the-counter (OTC) drugs. OTC is generally safer, but not absolutely safe, “especially when not taking the recommended dose.” Many people may know that eating too much acetaminophen can damage the liver and kidneys, but they may not understand that “NSAIDs may cause huge troubles for people with high blood pressure, coronary heart disease or heart failure”, so be very careful when using them.
He explained that NSAIDs may cause the body to accumulate salt and water (fluid overload), increase blood pressure, worsen heart failure, and reduce the function of blood vessel endothelial cells, among other problems, and there is evidence that when these drugs are taken, “the incidence of myocardial infarction increases. “.
Poorly controlled diabetes increases risk of hospitalization for heart failure
Xie Anmin said that the Journal of the American College of Cardiology published in AprilJACC“A Danish study with a control group analyzed the registration data of 331,189 diabetic patients and found that adults with diabetes but no history of heart failure “taking NSAIDs significantly increased the risk of hospitalization due to heart failure”, Among them, 23,308 people were hospitalized due to heart failure during the study period. “The incidence of hospitalization due to heart failure was 1.46 times higher when taking NSAIDs than when not taking them.” In addition, most of the hospitalized patients with heart failure are over 80 years old, have poorly controlled diabetes, and have never used NSAIDs before; the patients are also taking diuretics and drugs that inhibit the renin-angiotensin system.
Xie Anmin added that the above mentioned people who have never used NSAIDs before, the author did not explain much, but it may be because the study only included people who have never had heart failure, while those who have used NSAIDs before may have had heart failure or other reasons were not included in the study.
Xie Anmin continued to point out that this study shows that “NSAID-related heart failure patients have the same 5-year mortality rate as other heart failure cases.” The author believes that the problem caused by NSAIDs is not simply fluid overload. has a direct effect on the cardiovascular system and thus contributes to heart failure”. Possible effects include pulse irregularity, cardiac fibrosis, vasoconstriction, mild clinically undetectable inflammation, and elevated blood pressure.
However, Xie Anmin also mentioned that this study cannot determine the cause of heart failure, whether the above-mentioned pathological mechanism of the cardiovascular system is involved, but only reminds that fluid overload and cardiovascular system lesions are both involved in the occurrence of heart failure .
Carefully track the occurrence of adverse symptoms
Xie Anmin emphasized that diabetes and NSAIDs are known risk factors for heart failure. In fact, the elderly who take this kind of anti-inflammatory painkillers most often are also at risk of heart failure. Therefore, many people should be very cautious when using NASID, and carefully track the occurrence of adverse symptoms.
Xie Anmin reminded that Taiwan’s advertisements emphasizing that painkillers must have an anti-inflammatory effect to be effective are overwhelming. There may be undue pressure on people who need pain medications to choose pain medications that are best for them.
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2023-04-21 05:21:00
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