NSAID USE AND INCREASED CARDIOVASCULAR RISK

• DOI: 10.22533/at.ed.1593642328089

• Palavras-chave: -

• Keywords: -

• Abstract:

  Introduction: The indiscriminate use of non-steroidal anti-inflammatory drugs (NSAIDs) without medical advice has been representing an important public health problem in Brazil and in the world, due to the easy access to these drugs, associated with the lack of follow-up by health professionals to the users. Chronic NSAIDs. It is known that in high doses and without proper supervision, it can contribute to an increase in the occurrence of systemic arterial hypertension, heart failure and myocardial infarction. Therefore, adequate management of these patients who need the use of medication is essential. Methodology: This is a systematic review of the literature, based on searches in the PubMed/MEDLINE database using the descriptors “NSAIDs” AND “cardiovascular risk”. 384 articles were found. Articles between the years 2017 and 2022 were selected, and works deemed inappropriate to the theme were excluded, leaving
  10 articles. Discussion: NSAIDs are frequently applied in the treatment of chronic inflammatory pain. However, recent studies show that NSAIDs are associated with 30% of hospitalizations due to adverse reactions resulting from the misuse of these drugs. In this sense, the most affected systems are the cardiovascular and gastrointestinal, the latter due to COX-2 inhibition and reduced protection of the gastric mucosa. As for the cardiovascular scope, there is selective inhibition of the isoenzymes COX-1-responsible for the synthesis of thromboxane A2, regulation of renal function and blood flow-and COX-2, which acts on sodium excretion, on the production of prostacyclin 2, on vasodilation and antiplatelet function. Accumulation of body fluids was observed, due to homeostatic imbalance, causing heart failure and consequently increasing the risk of myocardial infarction. In addition, with an increase in sodium concentration and a decrease in prostacyclin synthesis, there is an increase in blood pressure, which can cause hypertension, especially in those with chronic use. Another consequence is atrial fibrillation, which despite not having a biological explanation, an increased risk of 12% was observed in patients using NSAIDs when compared to those who did not use them. Conclusion: It is identified that the chronic use of NSAIDs, associated with poor medical supervision, can cause cardiovascular impairment, thus being a necessary topic, which demands recurrent updates. Thus, the study emphasizes the need to use NSAIDs properly, in order to avoid cardiac and systemic repercussions in general.