We're unable to sign you in at this time. Please try again in a few minutes.
We were able to sign you in, but your subscription(s) could not be found. Please try again in a few minutes.
There may be a problem with your account. Please contact the AMA Service Center to resolve this issue.
Contact the AMA Service Center:
Telephone: 1 (800) 262-2350 or 1 (312) 670-7827  *   Email: subscriptions@jamanetwork.com
Error Message ......
Editor's Correspondence |

Arthritis Is Associated With Cardiovascular Disease in the Users of Analgesics and Nonsteroidal Anti-inflammatory Drugs

Fakhreddin Jamali, PhD
Arch Intern Med. 2007;167(21):2371-2372. doi:10.1001/archinte.167.21.2371-b.
Text Size: A A A
Published online


In the article by Forman et al1 titled “Frequency of Analgesic Use and Risk of Hypertension Among Men,” the authors conclude that the frequency of nonnarcotic analgesic use is independently associated with a moderate increase in the risk of incident hypertension. This conclusion is questionable because of an important omission. The authors have not considered, as a covariate, the underlying reason for the use of analgesics and anti-inflammatory drugs. It is well established that inflammatory diseases such as arthritis, which the examined drugs are used for, adversely affect the cardiovascular system so that patients with arthritis are afflicted with cardiovascular conditions to a significantly greater extent than the general population.24 This is associated with a rise in proinflammatory mediators. The presented data do not differentiate between the disease, its severity and progression, and the drugs. It is not surprising, therefore, that the patients who take the drugs every day (and hence, may be afflicted with more severe inflammatory diseases) have significantly higher risk ratios than those who do not take any analgesics and are presumably healthy. The authors, therefore, cannot conclude that the drugs alone were the cause of the increased risk of hypertension.

Sign in

Create a free personal account to sign up for alerts, share articles, and more.

Purchase Options

• Buy this article
• Subscribe to the journal

First Page Preview

View Large
First page PDF preview





Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.
Submit a Comment


Some tools below are only available to our subscribers or users with an online account.

Sign in

Create a free personal account to sign up for alerts, share articles, and more.

Purchase Options

• Buy this article
• Subscribe to the journal

Related Content

Customize your page view by dragging & repositioning the boxes below.

Articles Related By Topic
Related Collections
PubMed Articles

The Rational Clinical Examination EDUCATION GUIDES
Septic Arthritis