Wednesday, November 27, 2013

The painkillers that contain too much salt: Soluble versions of paracetamol, aspirin and ibuprofen put patients at 22% more risk of strokes

  • Millions of Britons could be at risk of early death due to painkillers
  • Soluble forms found to have 50 per cent more salt than the safe daily limit
  • Researchers behind the study now urging people to avoid the medication
BySophie Borland

Painkillers taken by millions of Britons may be causing heart attacks, strokes and early death because they contain so much salt, a major study shows.

Patients who regularly take soluble forms of aspirin, paracetamol, ibuprofen and other common drugs are 22 per cent more at risk of stroke and seven times more prone to high blood pressure, the researchers found.

They were also found to be 28 per cent more likely to die early.
Recommended doses of some of the painkillers were found to contain 50 per cent more salt than the safe daily limits for adults.

Soluble painkillers taken by million of Britons could be causing early death due to the amount of salt they contain, research shows
Soluble painkillers taken by million of Britons could be causing early death due to the amount of salt they contain, research shows

The researchers behind the study, carried out by University College London and the University of Dundee, are now warning patients to avoid regularly taking soluble painkillers.

And they are urging drugs firms to print labels similar to those on food packaging on the tablets – most of which are sold over the counter – warning patients about high levels of salt.

Millions of adults, particularly the elderly, rely on painkillers for long-term conditions such as arthritis, while supplements such as calcium are commonly taken by pregnant women and those going through the menopause.

Many prefer taking the soluble varieties as they are easier to swallow and are thought to get to work more quickly as they have already been broken down. But the medicines contain very high levels of salt as it helps them dissolve in water and produce a fizzing effect.

During the study, academics monitored patients who had been prescribed soluble forms of paracetamol, aspirin and ibuprofen as well as supplements such as vitamin D, zinc and calcium for an average of seven years.

They trawled 1.29million patient records obtained from GP surgeries across the UK.

Those taking the soluble pills for any length of time were 16 per cent more likely to suffer a heart attack, stroke or die early.

They also found that patients were 22 per cent more likely to suffer a stroke, 28 per cent more likely to die from any cause and seven times more likely to suffer high blood pressure.

On average, patients succumbed to these problems only four years after first being prescribed the drugs.

Certain painkillers were found to contain 50 per cent more salt than the safe daily limit

Government guidelines state that adults should eat no more than six grams of salt a day. Patients taking eight soluble paracetamol pills a day – the full daily dose – exceed this amount by 50 per cent.

The average adult eats about eight grams of salt a day, but experts calculate that if we all reduced that by three grams there would be 30,000 fewer heart attacks and strokes a year.

By comparison a packet of ready salted crisps contains half a gram of salt, while a packet of salt and vinegar has one gram. A bowl of cornflakes – the saltiest cereal – contains around 0.4 grams, while two slices of bread have about 0.8 grams.

The worst culprits are ready meals, which can contain seven grams per portion, and some ready-made sandwiches, which contain between three and four grams.
Professor Thomas Macdonald, of the University of Dundee, said: ‘We were surprised at how much salt there was in some tablets.

Researchers behind the study are now urging people not to take the soluble forms on a regular basis
Researchers behind the study are now urging people not to take soluble painkillers on a regular basis (library image)

‘All the foods we buy we can find out in intricate detail how much sodium (salt) there is but we can’t do that with medicines.’

He added: ‘It’s an avoidable risk and it’s a cardiovascular risk which is the commonest cause of death in Britain. If you take these drugs every day it would be better for your health to take the normal versions, not the soluble ones.’

The researchers only looked at patients prescribed the pills by their GP but they said millions of adults who buy them over the counter were also at risk.

Dr Jacob George, also from the University of Dundee, said: ‘These drugs are also available over the counter, they can be picked up in the supermarket.

‘We have no control over how many millions of people are buying these drugs.
Heart disease, which includes heart attacks and strokes, is by far the biggest killer in Britain. It claims 180,000 lives a year.

Experts pointed out that patients taking the pills occasionally were probably not damaging their health.

Dr Mike Knapton, Associate Medical Director at the British Heart Foundation, said: ‘We know that too much salt is linked to a higher risk of heart attack and stroke.

‘It’s important to remember that this research applies to people who are taking these medicines every day – this does not mean that occasional use could damage your heart health.

‘To give us an idea of whether these risks translate for medicines bought over the counter, we would need to see further research focusing on non-prescription medication.’

‘This is an important reminder for doctors and patients to carefully consider the risks and benefits of soluble or effervescent (fizzing) medicines at the time of prescription.’

Dr Li Wei, an expert in statistics who specialises in drugs safety at University College London’s School of Pharmacy, was also highly involved in the study.

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