The commonly used painkiller diclofenac is associated with an increased risk of major cardiovascular events, such as heart attack and stroke, compared with no use, paracetamol use, and use of other traditional painkillers, finds a study published by The BMJ this week.
The findings prompt the researchers to say that diclofenac should not be available over the counter, and when prescribed, should be accompanied by an appropriate front package warning about its potential risks, medicalxpress.com reported.
Diclofenac is a traditional non-steroidal anti-inflammatory drug (NSAID) for treating pain and inflammation and is widely used across the world.
But its cardiovascular risks compared with those of other traditional NSAIDs have never been examined in large randomized controlled trials, and current concerns about these risks make such trials unethical to conduct.
So a research team, led by Morten Schmidt at Aarhus University Hospital in Denmark, examined the cardiovascular risks of starting diclofenac compared with no NSAIDS, starting other traditional NSAIDs, and starting paracetamol.
The results are based on national registry data for more than 6.3 million adults in Denmark with at least one year of continuous prescription records before study entry in January 1996.
Participants were split into low, moderate, and high baseline cardiovascular risk. Average age was 46-49 years among participants starting NSAIDs and 56 years among those starting paracetamol.
After taking account of potentially influential factors, starting diclofenac during the study period (1996-2016) was associated with an increased rate of major adverse cardiovascular events within 30 days compared with starting other traditional NSAIDs (ibuprofen or naproxen) or starting paracetamol.
Events included irregular heart beat or flutter, ischaemic stroke, heart failure, and heart attack. The increased risks applied to men and women of all ages and also at low doses of diclofenac.
Starting diclofenac was also associated with an increased rate of cardiac death compared with no NSAIDs, and an increased risk of upper gastrointestinal bleeding compared with no NSAIDs, starting ibuprofen or paracetamol, but not with naproxen.
The authors point out that, although the relative risk was increased, the absolute risk remained low for the individual patient.
When results were analyzed by baseline cardiovascular risk, the absolute number of events per 1000 diclofenac starters per year also increased.
For example, among patients at low baseline risk, diclofenac starters had one additional event versus ibuprofen starters, one additional event versus naproxen starters, three additional events versus paracetamol starters, and four additional events versus no NSAIDs. Among patients at moderate baseline risk, corresponding figures were seven, seven, eight, and 14 additional events, respectively, and for those at high baseline risk, corresponding numbers were 16, 10, one, and 39 additional events, respectively.
This is an observational study, so no firm conclusions can be drawn about cause and effect. However, the study’s sample size is larger than most previous analyses of observational and randomized studies taken together and provides strong evidence to guide clinical decision making.
“Treatment of pain and inflammation with NSAIDs may be worthwhile for some patients to improve quality of life despite potential side effects,” they write. “Considering its cardiovascular and gastrointestinal risks, however, there is little justification to initiate diclofenac treatment before other traditional NSAIDs,” they concluded.
These Nutritious Breakfasts Can Give A Kick Start To Your Day: Do Try Them!
Breakfast is undoubtedly the most important meal of the day. It is the meal which kick-starts your metabolism and helps you burn calories throughout the day. Not only is it important for people who are trying to lose weight, it is simply important for a person to stay fit and healthy. Breakfast is the one meal which can give you the energy to do things and focus at your work and school. WebMD says that including breakfast in your diet can have positive effects on your memory and concentration.
Following are some breakfast options suggested by Delhi-based nutritionist Pooja Malhotra, which can give a boost your energy and also keep you warm during the chilly winter months.
Try these healthy breakfast options right now!
1. Stuffed rotis
Winter is the time when a variety of vegetables are in season. Stuffed rotis or paranthas made from methi (fenugreek), mooli (radish), gobi (cauliflower), matar (peas) or gajar (carrots) can all make for a delicious and wholesome winter breakfast. You can cook them with ghee (make sure you use it in the right quantity) and eat them with pickle and curd. Stuffed rotis are essentially the traditional Indian breakfast which people have been having for years. Prepare them as your grandmother used to prepare and enjoy them throughout winter.
2. Palak or beetroot roti with mint raita
Palak or spinach is a leafy geen veggie with more health benefits than you can count in your fingers. Similar is the case with beetroot, which is a root vegetable which is incredibly low in calories and is a great source of essential nutrients like fibre, folate and Vitamin C. Beetroot also contains nitrates and pigments which can help in controlling your blood pressure and may improve your overall athletic performance.
3. Egg parantha or scrambled eggs with chapati
Now that is a protein-rich breakfast which can help you keep full for longer. Prepare egg paranthas or eat scrambled eggs with roti for the perfect blend of protein, fat and carbs in your breakfast. Also, do not separate the yolk from egg white. A whole egg will provide you with all essential nutrients.
4. Bajra roti with beetroot raita/bajra khichdi
Bajra is a healthy grain which can be included a weight loss diet as well. You can either make a dough of bajra flour or prepare bajra khichdi as a healthy breakfast option. Bajra or millets has properties that can help in stabilising cholesterol levels in the body. Being rich in fibre, the grain is great for digestion and makes for a healthy breakfast option during winter.
(Pooja Malhotra is a nutritionist based in Delhi)
5 Super Healthy And Warm Drinks To Keep You Hydrated During Winter
Are the teas and coffees failing to keep you warm during the chilly winter? Then need not worry as we are right here with multiple options for warm and comforting drinks during winter. Warm drinking options are important to keep you hydrated during winter. Staying hydrated during summer seems to be way easier as cold and healthy drinks are aplenty. The easiest way to stay hydrated during summer is to simply gulp down a bottle of water. But in winter, the body is usually in need of something which keeps us warm and on-the-go. Keep reading if you want some alternative warm drinks instead of sipping on a third our fourth cup of coffee.
Drinks to keep you warm and hydrated during winter
Well, this is nothing but our very own haldi doodh. It is the traditional drink which is taken when a person is suffering from cold or fever. It is a healing drink which can naturally detox your body and even strengthen your bones.
Ginger, honey, lemon tea:
Yes, this is another traditional drink which can be taken in warm form as well. You can create a tea concoction by adding ginger, honey and lemon to water and bring to a boil. It can make for a refreshing and warming drink during the chilly winter months.
Hot mulled cider:
All you need to do is add cardamom, peppercorns, star anise, ginger, lemon and cloves to apple cider vinegar. Add a tinge of all these ingredients in a cup of ACV and heat it in low flame. The drink is going to make for a flavourful companion to you and your favourite book by the fireplace.
Vegetable/chicken/bone broth or soup:
Soups or broths are filling and extremely warming during the cold winter months. You can either prepare steaming hot vegetable soup or broth or chicken soup or bone breath. Broths and soups are fluids which can help you hydrated during winter while also boosting your immunity and protecting your from catching a cold or infection. Just make sure that their preparation is light and healthy.
Now this is a toasty treat you all have been craving! All you need is some warm milk, cinnamon, vanilla and some almonds. This velvety winter drink is going to be your all time favourite! What’s more is that you can prepare it beforehand and have it when you’re ready for a warm treat for yourself.
Fasting can improve overall health, study suggests
Fasting influences the circadian clock and fasting-driven cellular responses, which together work to achieve fasting-specific temporal gene regulation.
Fasting can lead to improved health and provide protection against ageing-associated diseases, a recent study suggests.
According to the research, fasting affects circadian clocks in the liver and skeletal muscle, causing them to rewire their metabolism, which can ultimately lead to improved health and protection against ageing-associated diseases. The study was published recently in Cell Reports.
The circadian clock operates within the body and its organs as intrinsic time-keeping machinery to preserve homeostasis in response to the changing environment. And, while food is known to influence clocks in peripheral tissues, it was unclear, until now, how the lack of food influences clock function and ultimately affects the body.
“We discovered fasting influences the circadian clock and fasting-driven cellular responses, which together work to achieve fasting-specific temporal gene regulation,” said lead author Paolo Sassone-Corsi.
“Skeletal muscle, for example, appears to be twice as responsive to fasting as the liver,” Paolo asserted.
According to the researchers, fasting is able to essentially reprogram a variety of cellular responses. Therefore, optimal fasting in a timed manner would be strategic to positively affect cellular functions and ultimately benefiting health and protecting against ageing-associated diseases.