PAINKILLERS commonly used to treat arthritis, post-surgery pain and frozen shoulder, can increase the risk of dying from a heart attack or stroke by fourfold, a study has found. Scientists have undertaken one of the most comprehensive studies on the cardiovascular effects of powerful painkillers and have concluded there is little evidence they are safe for the heart. They stressed that while the overall numbers of people suffering heart attacks or strokes while on the drugs is small, there are important risks associated with taking them. The drugs include ibuprofen which is available over the counter, without prescription and the authors have questioned if this should be allowed to continue. A total of11m prescriptions were written for the seven drugs included in the trial in England in 2009, costing around 76.7m. The drugs, called non-steroidal anti-inflammatory drugs (NSAIDS) and a subgroup of newer ones called COX-2 inhibitors, are known to affect the heart and one of them, Vioxx, was removed from sale in 2004 because of the increased risk of heart attacks. Since then doctors have questioned the safety of the whole class of similar drugs. The analysis, conducted by a team at Bern University, evaluated 31 studies involving over 116,000 patients who took the painkillers regularly, mostly for arthritis pain. The drugs were naproxen, ibuprofen, diclofenac, celecoxib, etoricoxib and two others not used in England, called rofecoxib or Vioxx, and lumiracoxib. It was found that compared with placebo, rofecoxib and lumiracoxib were associated with twice the risk of heart attack, while ibuprofen was associated with more than three times the risk of stroke. Etoricoxib and diclofenac were associated a fourfold risk of death from a heart attack or stroke. Naproxen appeared least harmful in terms of cardiovascular safety of the seven, the researchers said. The study only looked at people taking the drugs continuously and not those taking the odd painkiller for a headache or other minor ailment. The findings were published online by the British Medical Journal. Co-author Professor Peter Jni, of the Institute of Social and Preventive Medicine at the University of Bern in Switzerland, said: The use of other non-steroidal anti-inflammatory drugs not covered by our analysis should be reconsidered, as well as the over the counter availability of non-steroidal anti-inflammatory drugs such as diclofenac or ibuprofen. Telegraph