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NSAIDs and Heart Failure

Do you have a patient over sixty with a diagnosis of congestive heart failure taking a nonsteroidal anti-inflammatory drug (NSAID)? If so, be aware that their risk of hospitalization is increased by up to fifty percent of similar patients who do not take an NSAID.

In addition to heart failure, many over the counter pain relief drugs also cause blood pressure to rise, fluid to accumulate, and interfere with therapeutic aspirin. Although there is a small risk across the board of heart disease with NSAIDs, patients who already have a diagnosis of heart failure are at particular risk. Naproxen (Naprosyn and Aleve) increase the risk by 50 percent. Ibuprofen (Advil and Motrin), increase the risk of hospitalization in heart failure patients by 43 percent.

The controversy involving NSAIDs is hardly new. Many patients choose to live with an increased risk of heart failure instead of suffering the daily pain of severe arthritis. These patients are not the ones I am concerned about.

I am more concerned about the patients who have normal or occasional pain and take the first OTC pain reliever they find. How many patients do you have with heart failure with Ibuprofen ordered when Tylenol might have sufficed without increasing the risk of heart disease? When reviewing medications, try to identify patients who might benefit from Tylenol instead of NSAIDs and you may possibly avoid a hospitalization or two.

Information for this post was taken from WebMD. In the near future, expect to see more ways that you might reduce your hospitalization rate and improve the quality of life for patients with heart failure. When it comes time to implement OASIS-C or compare your agency’s acute hospitalization rate against your competitors, you will be in good shape!

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