Daily use of ibuprofen or other over-the-counter anti-inflammatory pain relievers may limit the heart attack protection abilities of aspirin according to a recent study published by the American Heart Association.

Although the findings are not conclusive, there appears to be evidence that the heart benefits attributed to aspirin are compromised when an over-the-counter anti-inflammatory pain reliever (non-steroidal anti-inflammatories or NSAIDs) is taken daily. While daily use may cause the conflict, researchers are confident that casual or intermittent use of this type of pain reliever does not interfere with aspirin’s heart-protective effects.

The results of the study are provocative enough to warrant further study, but lead researcher Tobias Kurth, MD, said that it is “too early to make recommendations or put warning labels on bottles, but if the patient was a regular NSAID user, it did interfere with aspirin.”

Kurth is an epidemiologist in Preventive Medicine at Brigham and Women’s Hospital in Boston, Mass.

The five-year study included over 22,000 healthy male doctors, half took 325 mg aspirin on alternate days; half took a placebo. The aspirin group had 44 percent fewer heart attacks than the placebo group – 139 heart attacks in the aspirin group; 239 in the placebo group. Those who regularly took ibuprofen and other common anti-inflammatory drugs did not get the protective effect historically attributed to aspirin.

However, relatively few heart attacks were recorded in those who took anti-inflammatory drugs intermittently, which can be described as less than 60 days per year. Aspirin was observed to still provide protection from heart attacks amongst that group.

While these findings are note worthy, Kurth is quick to point out that there may be conditions that allow for both aspirin and over-the-counter NSAIDs to be taken. Kurth believes that simply ingesting aspirin a couple of hours before taking an NSAID may do the trick. While he thinks that timing each dosage may be the answer, he was careful to add that more data needs to be collected on the method before it can be considered a viable solution.

Aspirin is the first line of defense in preventing heart disease, because it blocks a critical substance – the Cox-1 enzyme, which leads to clots that can cause heart attacks. But over-the-counter NSAIDs also interact with the Cox-1 enzyme to reduce inflammation and pain. It has long been speculated that a conflict existed between the two drugs, but until this study, no findings had supported the belief.