Harvard Heart Letter：止痛药增加心脏病发作的风险

www.yongyao.net　　2006-10-16 14:09:14　　来源：　　责任编辑：

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据2006年十月Harvard Heart Letter期刊报道：心血管副作用不仅仅见于服用新型止痛药COX-2 阻滞剂，其它常用的药物ibuprofen 和阿司匹林也有这种副作用。COX-2 阻滞剂与常用止痛药物Celebrex， Vioxx 和 Bextra是同一类药物。虽然传统药物的心血管副作用微小，但是亦应引起重视。

Ibuprofen, aspirin, 和COX-2s 都属于非甾族的抗炎症药物。大多数这类药物有增加血压的作用，从而能影响一些血压药物的效果。除此之外，这类药物还能损害血管舒张的功能，并有可能刺激动脉血管内平滑肌细胞的增长。所有的这些变化促进一种动脉阻塞的进程－动脉粥样硬化。

研究人员指出服用COX-2 阻滞剂会增加心脏病发作的机会。Vioxx 就是因为可能导致心脏疾病的并发症才被撤出市场的，而且Vioxx 还有可能引起更为严重的心衰。同样，传统的非甾族的抗炎症药物也会导致这样严重的疾病。一般来说，止痛药物的心血管副作用大多发生于患有心脏病的人或那些处于心脏病高风险的人群。

来源：http://www.health.harvard.edu/newsletters/Harvard_Heart_Letter.htm

Painkillers—new and old—increase the risk for heart attack, from the Harvard Heart Letter

Cardiovascular side effects aren’t limited to the use of the newer painkillers called COX-2 inhibitors—a category that includes Celebrex and the recently discontinued Vioxx and Bextra. Old standbys, like ibuprofen and aspirin, aren’t entirely blameless, reports the October 2006 issue of the Harvard Heart Letter. The cardiovascular risks associated with traditional NSAIDs are small, but worth being aware of.

Ibuprofen, aspirin, and COX-2s all belong to the class of medicines called nonsteroidal anti-inflammatory drugs (NSAIDs). Most of them boost blood pressure and can counteract the effect of some blood-pressure drugs. They can also impair blood vessels ability to relax and may stimulate the growth of smooth muscle cells inside arteries. All these changes can contribute to the artery-clogging process known as atherosclerosis.

Researchers have determined that use of a COX-2 inhibitor increases the chances of having a heart attack. Vioxx, which was taken off the market because of possible heart complications, may lead to or worsen heart failure—but so can traditional NSAIDs. In general, cardiovascular side effects are most likely to happen in people with existing heart disease or those at high risk for it.

The Heart Letter offers a simple table to help people make an informed choice about pain relievers. That choice depends in part on whether you are also taking aspirin to protect your heart. If NSAIDs upset your stomach, try taking them along with an acid blocker. If you don’t get relief from a traditional NSAID and you don’t have heart disease or its risk factors, don’t rule out a COX-2 inhibitor. （2006.10.16）

来源：37度医学网