New data suggests that two common painkillers, ibuprofen and diclofenac, can slightly increase the risk of heart problems if taken in high doses for a long time.
People with severe arthritis often take the drugs, which also calm inflammation, to go about daily life.
The researchers said some patients would deem the risk acceptable, but they should be given the choice.
A study, published in the Lancet, showed the drugs posed even greater risks for smokers and the overweight.
The risks have been reported before, but a team of researchers at the University of Oxford analyzed the issue in unprecedented detail in order to help patients make an informed choice.
The group investigated more than 353,000 patient records from 639 separate clinical trials to assess the impact of non-steroidal anti-inflammatory drugs.
They looked at high-dose prescriptions levels, rather than over-the-counter pain relief, of 150 mg diclofenac or 2,400 mg ibuprofen each day.
They showed that for every 1,000 people taking the drugs there would be three additional heart attacks, four more cases of heart failure and one death as well cases of stomach bleeding – every year as a result of taking the drugs.
Common painkillers ibuprofen and diclofenac can slightly increase the risk of heart problems if taken in high doses for a long time
So the number of heart attacks would increase from eight per 1,000 people per year normally, to 11 per 1,000 people per year with the drugs.
“Three per thousand per year sounds like it is quite a low risk, but the judgement has to be made by patients,” said lead researcher Prof. Colin Baigent.
He added: “So if you’re a patient and you go and sit in front of your doctor and discuss it, you are the one who should be making the judgement about whether three per thousand per year is worth it to allow you, potentially, to go about your daily life.”
He said this should not concern people taking a short course of these drugs, for example for headaches.
However, he did warn that those already at risk of heart problems would be at even greater risk as a result of the high-dose drugs.
High blood pressure, cholesterol and smoking all increase the risk of heart problems.
Prof. Colin Baigent said: “The higher your risk of heart disease, the higher your risk of a complication. Roughly speaking, if you’ve got double the risk of heart disease, then the risk of having a heart attack is roughly doubled.”
He said patients should consider ways to reduce their risk, which could include statins for some patients.
A similar drug called rofecoxib (known as Vioxx), was voluntarily taken off the market by its manufacturer in 2004 after similar concerns were raised.
A third drug, naproxen, had lower risks of heart complications in the study and some doctors are prescribing this to higher-risk patients.
The drug does a similar job to aspirin by stopping the blood from clotting although this also increases the odds of a stomach bleed.
Obese people can be physically healthy and fit and at no greater risk of heart disease or cancer than normal weight people, a new research found.
The key is being “metabolically fit”, meaning no high blood pressure, cholesterol or raised blood sugar, and exercising, according to experts.
Looking at data from over 43,000 US people they found that being overweight per se did not pose a big health risk.
The results are published in the European Heart Journal.
In the study at the University of South Carolina, more than a third of the participants were obese.
Of these 18,500, half were assessed as metabolically healthy after a physical examination and lab tests.
Obese people can be physically healthy and fit and at no greater risk of heart disease or cancer than normal weight people
This subset of metabolically healthy obese people who did not suffer from conditions such as diabetes, high cholesterol or high blood pressure, were generally fitter and exercised more than the other obese people.
And their risk of developing or dying from cardiovascular disease or cancer was identical to people of ideal weight and was half that of “metabolically less fit” obese people.
Lead researcher Dr. Francisco Ortega, who currently works at the University of Granada in Spain, said the findings show that getting more exercise can keep you healthier, even if you still carry a bit of extra weight.
“This research highlights once again the important role of physical fitness as a health marker.”
Most of the men and women in the study came from a similar background, meaning the results may not apply to everyone. They were mostly Caucasian, well educated, and worked in executive or professional positions.
An analysis of 20 studies showed that eating dark chocolate daily resulted in a slight reduction in blood pressure.
The Cochrane Group’s report said chemicals in cocoa, chocolate’s key ingredient, relaxed blood vessels.
However, there are healthier ways of lowering blood pressure.
The theory is that cocoa contains flavanols which produce a chemical in the body called nitric oxide. This “relaxes” blood vessels making it easier for blood to pass through them, lowering the blood pressure.
An analysis of 20 studies showed that eating dark chocolate daily resulted in a slight reduction in blood pressure
However, studies have thrown up mixed results. The Cochrane analysis combined previous studies to see if there was really an effect.
There was a huge range in the amount of cocoa consumed, from 3 g to 105 g a day, by each participant. However, the overall picture was a small reduction in blood pressure.
A systolic blood pressure under 120 mmHg (millimetres of mercury) is considered normal. Cocoa resulted in a 2-3 mmHg reduction in blood pressure. However, the length of the trials was only two weeks so the longer term effects are unknown.
Lead researcher Karin Ried, from the National Institute of Integrative Medicine in Melbourne, Australia, said: “Although we don’t yet have evidence for any sustained decrease in blood pressure, the small reduction we saw over the short term might complement other treatment options and might contribute to reducing the risk of cardiovascular disease.”
High blood pressure is both common and deadly. It has been linked to 54% of strokes worldwide and 47% of cases of coronary heart disease.
However, chocolate packs plenty of fat and sugar as well as cocoa so is not the ideal way of lowering blood pressure.
There has also been a warning in the Lancet medical journal that dark chocolate may contain fewer flavanols than you might think. Dark chocolate contains a higher cocoa count than milk chocolate so should contain more flavanols, however, they can also be removed as they have a bitter taste.