A: You probably are referring to a recent study that got a lot of publicity. The study looked only at patients who already were at increased risk of vascular disease; it wanted to see how nonsteroidal anti-inflammatory drugs (NSAIDs) — including the selective cox-2 inhibitor diclofenac, and ibuprofen and naproxen — affected them.
The findings: Naproxen seems to pose the least risk for vascular complications in folks with cardiovascular problems.
Cox-2 inhibitors and perhaps ibuprofen seem to be the more risky choices. But you need to know a bit more.
First, cox-2 inhibitors were developed in part to help protect the stomach (and sometimes intestinal) lining, because traditional NSAIDs can cause internal bleeding. However, almost a decade ago, two cox-2 inhibitors, rofecoxib (Vioxx) and valdecoxib (Bextra), were taken off the market because they increased many people's risk for stroke and heart attack.
But cox-2 inhibitors that are still available, such as celecoxib and the newer versions like diclofenac, have helped a lot of people manage chronic inflammation and pain. When they're prescribed and administered by a competent medical professional, they are useful.
And if you are at risk for adverse stomach and intestinal reactions, your doctor may recommend diclofenac.
On the other hand, if you're at risk for a second heart attack or stroke, maybe you need to take naproxen or aspirin instead.
Each patient needs to talk with his or her doctor to determine the best choice of medication; it depends on your overall health profile.
And we are fans of aspirin — an effective anti-inflammatory pain reliever that appears to have many other far-reaching benefits, from potential anti-cancer properties to protection against dementia. But it, too, can be hard on the stomach, so always take it with a glass of warm water before and after. And that's not a bad system for taking any NSAID, either.
Mehmet Oz, M.D. is host of “The Dr. Oz Show,” and Mike Roizen, M.D. is chief wellness officer and chair of wellness institute at Cleveland Clinic. Email your health and wellness questions to them at firstname.lastname@example.org.