Abstract

Nonsteroidal anti-inflammatory drugs (NSAIDs) include aspirin, other traditional NSAIDs, and coxibs. Evidence obtained during the past 10 years has focused attention on the cardiovascular hazard associated with coxibs and some traditional NSAIDs. The large randomized trials of prolonged coxib treatment added importantly to information provided by epidemiological studies that had previously associated regular use of NSAIDs with increased blood pressure and enhanced risk of congestive heart failure, and identified an increased risk of myocardial infarction as a class effect of cyclooxygenase-2 inhibitors. The aim of this article is to review the cardiovascular effects of aspirin, other traditional NSAIDs, and coxibs, to discuss the mechanisms underlying these effects, and to provide a clinical perspective on the cardiovascular hazard associated with their use.

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