title: Harmful effects of NSAIDs among patients with hypertension and coronary artery disease.
abstract: BACKGROUND
  There is limited information about the safety of chronic nonsteroidal anti-inflammatory drugs (NSAIDs) in hypertensive patients with coronary artery disease.
  
  
  METHODS
  This was a post hoc analysis from the INternational VErapamil Trandolapril STudy (INVEST), which enrolled patients with hypertension and coronary artery disease. At each visit, patients were asked by the local site investigator if they were currently taking NSAIDs. Patients who reported NSAID use at every visit were defined as chronic NSAID users, while all others (occasional or never users) were defined as nonchronic NSAID users. The primary composite outcome was all-cause death, nonfatal myocardial infarction, or nonfatal stroke. Cox regression was used to construct a multivariate analysis for the primary outcome.
  
  
  RESULTS
  There were 882 chronic NSAID users and 21,694 nonchronic NSAID users (n = 14,408 for never users and n=7286 for intermittent users). At a mean follow-up of 2.7 years, the primary outcome occurred at a rate of 4.4 events per 100 patient-years in the chronic NSAID group, versus 3.7 events per 100 patient-years in the nonchronic NSAID group (adjusted hazard ratio [HR] 1.47; 95% confidence interval [CI], 1.19-1.82; P=.0003). This was due to an increase in cardiovascular mortality (adjusted HR 2.26; 95% CI, 1.70-3.01; P<.0001).
  
  
  CONCLUSIONS
  Among hypertensive patients with coronary artery disease, chronic self-reported use of NSAIDs was associated with an increased risk of adverse events during long-term follow-up.
authors: Department of Medicine, College of Medicine, University of Florida, Gainesville, 32610-0277, USA. bavryaa@medicine.ufl.edu
authors: Anthony A
authors: AA
authors: Bavry
authors: Asma
authors: A
authors: Khaliq
authors: Yan
authors: Y
authors: Gong
authors: Eileen M
authors: EM
authors: Handberg
authors: Rhonda M
authors: RM
authors: Cooper-Dehoff
authors: Carl J
authors: CJ
authors: Pepine
references: Circulation. 2006 Mar 28;113(12):1578-87
references: 16534006
references: BMJ. 2006 Jun 3;332(7553):1302-8
references: 16740558
references: Am J Med. 2007 Oct;120(10):863-70
references: 17904457
references: Circulation. 2006 Jun 27;113(25):2906-13
references: 16785336
references: BMJ. 2005 Jun 11;330(7504):1366
references: 15947398
references: BMJ. 2002 Jan 12;324(7329):71-86
references: 11786451
references: Am J Manag Care. 2002 Oct;8(15 Suppl):S383-91
references: 12416788
references: Lancet. 2003 Feb 15;361(9357):573-4
references: 12598144
references: Dig Dis. 1995 Mar-Apr;13(2):119-29
references: 7586632
references: Circulation. 2003 Sep 9;108(10):1191-5
references: 12939216
references: Ann Pharmacother. 2007 Jul;41(7):1163-73
references: 17609238
references: Circulation. 2007 Mar 27;115(12):1634-42
references: 17325246
references: BMJ. 2003 Dec 6;327(7427):1322-3
references: 14656840
references: N Engl J Med. 1999 Jun 17;340(24):1888-99
references: 10369853
references: N Engl J Med. 2001 Dec 20;345(25):1809-17
references: 11752357
references: Lancet. 2005 Feb 5-11;365(9458):475-81
references: 15705456
references: Curr Opin Rheumatol. 2002 Mar;14(2):115-20
references: 11845015
references: JAMA. 2006 Oct 4;296(13):1633-44
references: 16968831
references: Circ Cardiovasc Qual Outcomes. 2010 Jul;3(4):395-405
references: 20530789
references: Am Heart J. 2009 Apr;157(4):606-12
references: 19332185
references: J Am Geriatr Soc. 2009 Aug;57(8):1331-46
references: 19573219
references: N Engl J Med. 2000 Nov 23;343(21):1520-8, 2 p following 1528
references: 11087881
references: Ann Intern Med. 1994 Aug 15;121(4):289-300
references: 8037411
references: N Engl J Med. 2005 Mar 17;352(11):1071-80
references: 15713944
references: Clin Cardiol. 2009 Sep;32(9):E22-8
references: 19645040
references: Metab Syndr Relat Disord. 2010 Aug;8(4):295-305
references: 20367223
references: J Am Coll Cardiol. 2005 Apr 19;45(8):1295-301
references: 15837265
references: JAMA. 2003 Dec 3;290(21):2805-16
references: 14657064
references: Lancet. 2004 Dec 4-10;364(9450):2021-9
references: 15582059
references: Postgrad Med. 2009 Nov;121(6):9-20
references: 19940413
references: Arch Neurol. 2008 Jul;65(7):896-905
references: 18474729
references: N Engl J Med. 2005 Mar 17;352(11):1092-102
references: 15713943
references: BMJ. 2011 Jan 11;342:c7086
references: 21224324
references: Curr Med Res Opin. 2007 Oct;23(10):2395-404
references: 17714606
references: Circulation. 2008 Apr 22;117(16):2104-13
references: 18378608