Patients with arthritis are commonly prescribed non-steroidal anti-inflammatory drugs (NSAIDs). Typical of the class are ibuprofen, naproxen, diclofenac, indomethacin and meloxicam. The Spanish Centre for Pharmacoepidemiological Studies in Madrid used the UK General Practice Research Database to compare the risks for those taking NSAIDs with those who were not.

Heart failure, a relatively common condition, especially in the elderly, arises when the heart no longer has the power to pump blood effectively.

The team reports in Heart that taking NSAIDs increases the risk of getting heart failure by 30 per cent, after other factors are taken into account. It measured admission to hospital with heart failure, information accessible through the database, but was unable to say whether the risk of dying was similarly increased.

Of all those admitted to hospital with heart failure, 14 per cent were taking NSAIDs, compared with 10 per cent of a randomly selected sample. Half were aged 70 to 79. Of the NSAIDs, indomethacin seems to carry the greatest risk, tripling the chance of hospital admission with heart failure.

The results mean that, for every 1,000 people aged 60 to 84, taking NSAIDs would lead to one extra hospital admission. This could rise to three among older patients with other health problems such as diabetes, high blood pressure or kidney failure.

The study does not look at the modern alternatives to NSAIDs, called COX-2 inhibitors. Vioxx, one of this class, has already been withdrawn for increasing the risk of heart attack and stroke in a trial.

Many patients with osteoarthritis need NSAIDs to make life endurable, so the extra risk of heart failure is unlikely to change their habits. But the study does emphasise the need for powerful painkillers with fewer side-effects.

• Too few British people are given statin drugs to make much impact on death rates, a study reported in Heart has shown. Statins, cholesterollowering drugs that are highly effective at cutting death rates, are currently prescribed only for relatively high-risk patients — those who have had a previous heart attack or stroke, or whose cholesterol levels are higher than normal.

  To have a significant effect on deaths, as many as three quarters of middle-aged men need to be prescribed the drugs, according to the team led by Paul Durrington, of Manchester Royal Infirmary.

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