Nonsteroidal anti-inflammatory drugs and the heart: what is the danger?

Nonsteroidal anti-inflammatory drugs (NSAIDs) and selective cyclooxygenase (COX-2) inhibitors, or "coxibs," are used for a number of disease conditions for relief of pain and inflammation. Currently available data suggest concern for prothrombotic risk with coxibs and some NSAIDs, and the magnitude of risk may vary with individual agents. NSAIDs and coxibs also increase blood pressure, worsen hypertension control, and may precipitate heart failure, with important differences among agents. Physicians should consider patterns of risk and benefit in selecting the most appropriate agent for individual patients based on the individual gastrointestinal and cardiovascular risk profile.