Pain relief is a significant issue for many people, and the wealth of pain medication out there can be overwhelming. While consumers benefit from a variety of choices on the market, it is important to consider the potential for adverse side effects when taking any sort of medication. Now, researchers are observing that certain pain relievers are associated with an increased risk for cardiovascular mortality when taken by healthy people.

The drugs in question are known as nonsteroidal anti-inflammatory drugs, or NSAIDs, which include acetaminophen, ibuprofen, and aspirin. NSAIDs are available either with a prescription or over the counter (OTC) and are used extensively by the general public to help alleviate pain and inflammation that can stem from temporary as well as chronic conditions, including arthritis. The potential harmful effects of NSAIDs have been studied in the past in relation to people with health problems, but this was the first study to look at their usage in otherwise healthy people.

To arrive at their findings, published in the journal Circulation: Cardiovascular Quality and Outcomes, doctors examined the medical records of over one million healthy individuals with a median age of 39 years. Collecting data over the course of nine years, at least 44.7% of the study population took a NSAID during that time, though most used them in low doses for about two weeks. The researchers then compared their health outcomes relative to whether or not they took NSAIDs. Specific criteria were used to designate individuals as healthy.

What the researchers found was that when certain NSAIDs were used, there were patterns that suggested an increased rate of heart disease, with some elevating the risk by as much as 91%. Some of the drugs studied were associated with a two to three times greater risk for having a heart attack. The authors indicate that even though the overall frequency of these adverse effects is relatively low, patients should, at the very least, be aware that the risks exist and be allowed to make an informed decision.

While the findings were based in Europe, they are in fact in line with statements made by the American Heart Association that advise doctors about the evidence that NSAIDs, with the exception of aspirin, may increase the risk for heart attack or stroke in patients who use them for chronic pain. For individuals who are at a higher risk for cardiovascular conditions, doctors are advised to factor in a patient’s risk profile when developing a pain management regimen.

It is therefore recommended that patients who are regular user of NSAIDs speak to their doctors about why those drugs were chosen and whether or not treatment should continue.