Do NSAIDs Increase CVD Risk in Patients with Osteoarthritis?

While osteoarthritis (OA) is an independent risk factor for cardiovascular disease (CVD), findings from a new study presented at the 2018 Annual European Congress of Rheumatology suggested that the use of non-steroidal anti-inflammatory drugs (NSAIDS) contribute to a substantial proportion of this risk.

“Our study is the first to evaluate the mediating role of NSAID use in the OA-CVD relationship based on population-based health administrative data,” the researchers said.

In the longitudinal study, the researchers linked health administrative data of 7,743 participants with OA and 23,229 age- and sex-matched controls without OA living in British Columbia, Canada. The risk of developing incident CVD was assessed as the primary outcome. The risk for ischemic heart disease (IDH), congestive heart failure (CHF), and stroke were assessed as secondary outcomes. In addition, the researchers investigated the mediating effects of NSAIDS on the risk of developing CVD. 

After adjustments for socioeconomic status, body mass index, hypertension, diabetes, hyperlipidemia, chronic obstructive pulmonary disease, and Romano comorbidity score, the researchers found that individuals with OA had a 23% higher risk for developing CVD compared with those without OA (adjusted hazard ratio [HR] 1.23). In addition, the adjusted HR for IHD, CHF, and stroke were 1.17, 1.42, and 1.14, respectively.

Current NSAID use mediated approximately 67.51% of the total effect of OA on the increased risk of CVD. Likewise, current NSAID use mediated approximately 44.77% of the total effect of OA on increased CHF risk, and more than 90% on the total effect of OA on increased IHD and stroke risks.

“The results of this study indicate that OA is an independent risk factor for CVD,” the researchers concluded. “Our findings suggest that the mediating role of NSAID use substantially contributes to the OA-CVD association.”

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