COX-2 enzyme inhibitors and heart failure

A: NSAIDs and COX-2 enzyme inhibitors are not likely to induce a first occurrence of heart failure (HF),1 but should be avoided in people with pre-existing HF as they are strongly correlated with relapse.1-3

A major goal of HF management is to identify and reverse precipitating factors.2 The majority of patients with HF have concurrent hypertension, and blood pressure control will further reduce HF events.3 It is best to avoid salt-retaining agents that may increase blood pressure, such as COX-2 enzyme inhibitors and NSAIDs.2-4

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