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In heart failure, the kidney is exquisitely dependent upon vasodilating prostaglandins to maintain renal perfusion and salt and water balance. Nonsteroidal anti-inflammatory drugs (NSAIDs) decrease prostaglandin synthesis and, thus, may precipitate fluid retention in patients with heart failure.
In this report from the population-based, prospective Rotterdam Study, researchers evaluated the association of NSAID use with new-onset heart failure and with worsening heart failure in 7227 patients (mean age, 70). Patients already diagnosed with heart failure and those with baseline left-ventricular dysfunction, as determined by echocardiography, were excluded. The study period was July 1991 through December 1998. Two research physicians rigorousl…