Ibuprofen and other common painkillers are linked to an increased risk of cardiac arrest, according to a new Danish study published in the European Heart Journal—Cardiovascular Pharmacotherapy. The authors say these drugs should be used with caution and that people with heart problems may want to avoid them.Nonsteroidal anti-inflammatory drugs, or NSAIDs, are among the most commonly used drugs worldwide. Previous studies have linked them to increased risk of heart attack and stroke, heart failure and high blood pressure. Because some of them are sold over the counter, experts worry that people perceive them as safe and free of side effects.

When they broke their results down by specific medications, diclofenac—which is also sold by prescription in the United States—was associated with a 50% increased risk, and prescription-strength ibuprofen with a 31% increased risk.

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“I would say the message here is to be careful taking nonsteroidals, particularly high doses, and particularly if you have a preexisting cardiovascular disease. If you have any doubt about your heart health or your individual risk factors, talk to your doctor.