Article Text

Download PDFPDF
Non-steroidal anti-inflammatory drugs and risk of first hospital admission for heart failure in the general population
  1. C Huerta1,
  2. C Varas-Lorenzo2,
  3. J Castellsague2,
  4. L A García Rodríguez1
  1. 1CEIFE, Spanish Center for Pharmacoepidemiologic Research, Madrid, Spain
  2. 2Pfizer Global Epidemiology, Safety & Risk Management, Barcelona, Spain
  1. Correspondence to:
    Dr Consuelo Huerta
    Centro Español de Investigación Farmacoepidemiológica (CEIFE), Almirante 28; 2°, 28004 Madrid, Spain; chuerta{at}


Objectives: To estimate the risk of a first hospital admission for heart failure (HF) associated with the use of non-steroidal anti-inflammatory drugs (NSAIDs).

Methods: Cohort study with a nested case–control analysis based on the UK General Practice Research Database. Overall, 1396 cases of first hospital admission for non-fatal HF were identified (January 1997 to December 2000) and compared with a random sample of 5000 controls.

Results: The incidence rate was 2.7/1000 person years. Prior clinical diagnosis of HF was the main independent risk factor triggering a first HF hospitalisation (relative risk 7.3, 95% confidence interval (CI) 6.1 to 8.8). The risk of a first hospital admission for HF associated with current use of NSAIDs was 1.3 (95% CI 1.1 to 1.6) after controlling for major confounding factors. No effects of dose and duration were found. The relative risk in current users of NSAIDs with prior HF was 8.6 (95% CI 5.3 to 13.8) compared with patients who did not use NSAIDs and without prior clinical diagnosis of HF.

Conclusion: Use of NSAIDs was associated with a small increase in risk of a first hospitalisation for HF. In patients with prior clinical diagnosis of HF, the use of NSAIDs may lead to worsening of pre-existing HF that triggers their hospital admission. This increased risk, although small, may result in considerable public health impact, particularly among the elderly.

  • ACE, angiotensin-converting enzyme
  • GPRD, General Practice Research Database
  • HF, heart failure
  • MHRA, Medicines and Healthcare products Regulatory Agency
  • NSAID, non-steroidal anti-inflammatory drug
  • RR, relative risk
  • S, synergy index

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.


  • Published Online First 22 May 2006

  • This study was supported by a research grant from Pfizer.