Abstract | BACKGROUND: Nonsteroidal antiinflammatory drugs ( NSAIDs) have been associated with increased risk of adverse cardiovascular events prompting labeling revisions cautioning their use among patients with cardiovascular disease (CVD). However, little is known regarding long-term trends in real-world prescribing of NSAIDs within the CVD population. We aimed to characterize the use of prescription NSAIDs among U.S. adults with CVD from 1988 to 2016. METHODS: We used the National Health and Nutrition Examination Survey cross-sectional data from 1988-1994 and 19992016 to identify participants aged greater than or equal to 18 years with hypertension (defined by self-report, mean blood pressure ≥ 140/90 mm Hg, or antihypertensive medication use), or aged greater than or equal to 20 years with self-reported congestive heart failure (CHF), coronary heart disease (CHD), angina, myocardial infarction (MI), or stroke. Prevalence of prescription NSAID use was analyzed in 6-year examination periods. Weighted logistic regression was performed to test time trends in prescription NSAID use. RESULTS: Overall, prescription NSAID use declined among all CVD populations. The highest prevalence of overall prescription NSAID use was observed during the 1999-2004 examination years, thereafter declining through the 2005-2010 and 2011-2016 examination years: in patients with hypertension (13.9% [1999-2004] to 8.5% [2011-2016]), CHF (14.6%-8.5%), CHD (16.3%-7.4%), angina (17.6%-8.5%), MI (16.1%-9.0%), and stroke (15.7%-7.9%). Decreased use of COX-2-selective inhibitors was observed during the same period; whereas, nonselective NSAID use remained relatively stable. Trends in prescription NSAID use were reflective of the general adult population. CONCLUSIONS: Prescription NSAID use among patients with CVD appears to have declined from 1988 to 2016, primarily due to reduced COX-2-selective inhibitor use. Nonetheless, the prevalence of prescription NSAIDs has persisted among a subset of high-risk CVD populations.
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Authors | Andrew Y Hwang, Steven M Smith |
Journal | Pharmacotherapy
(Pharmacotherapy)
Vol. 41
Issue 3
Pg. 247-256
(03 2021)
ISSN: 1875-9114 [Electronic] United States |
PMID | 33231878
(Publication Type: Journal Article, Research Support, N.I.H., Extramural)
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Copyright | © 2020 Pharmacotherapy Publications, Inc. |
Chemical References |
- Anti-Inflammatory Agents, Non-Steroidal
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Topics |
- Adult
- Anti-Inflammatory Agents, Non-Steroidal
(therapeutic use)
- Cardiovascular Diseases
(drug therapy)
- Cross-Sectional Studies
- Humans
- Nutrition Surveys
- Prescriptions
(statistics & numerical data)
- United States
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