Study Links NSAID Use to Higher Cardiovascular Risks in Patients with Osteoarthritis

    Non-steroidal anti-inflammatory drugs (NSAIDs) can help to control the pain and inflammation of osteoarthritis (OA), but a study published online ahead of print by Arthritis & Rheumatology suggests that NSAIDs contribute to cardiovascular side effects in patients with OA.

    Using a population‐based cohort of 720,055 residents of British Columbia, Canada, the researchers from the University of British Columbia in Vancouver matched 7743 OA patients with 23,229 non-OA controls. Their primary outcome measure was risk of developing cardiovascular disease, with secondary outcomes of risk of developing ischemic heart disease, congestive heart failure, or stroke.

    After adjusting for patient factors, including BMI, hypertension, and diabetes, the researchers found that:

    • The risk of cardiovascular disease was 23% higher for patients with OA than for those who did not have OA
    • The risk of ischemic heart disease was 17% higher for OA patients
    • The risk of congestive heart failure was 42% higher for OA patients
    • The risk of stroke was 14% higher for OA patients

    Approximately 41% of the increased risk of cardiovascular disease among patients with OA was mediated through their NSAID use, the researchers found. NSAIDs also played a substantial role in the development of the secondary outcomes evaluated in the study.

    “To the best of our knowledge, this is the first longitudinal study to evaluate the mediating role of NSAID use in the relationship between osteoarthritis and cardiovascular disease in a large population based sample,” said senior study author Aslam Anis, PhD, FCAHS, of the School of Population and Public Health at the University of British Columbia.

    “Our results indicate that osteoarthritis is an independent risk factor for cardiovascular disease and suggest a substantial proportion of the increased risk is due to the use of NSAIDs. This is highly relevant because NSAIDs are some of the most commonly used drugs to manage pain in patients with osteoarthritis.

    “It’s important for people with OA to talk to their care providers and discuss the risks and benefits of NSAIDs.”


    Atiquzzaman M, Karim ME, Kopec J, Wong H, Anis AH. Role of non‐steroidal anti‐inflammatory drugs (NSAIDs) in the association between osteoarthritis and cardiovascular diseases: a longitudinal study. Arthritis Rheumatol. 2019 Aug 6. doi: 10.1002/art.41027. [Epub ahead of print].