Naproxen looks heart-safest in trials and riskiest in the records
Pooled randomised trials put it at 0.93 for major vascular events, the only drug group with no excess. Pooled prescribing databases put its first-week odds at 1.53.
What the study found
Naproxen came out safest in trials and highest in one big database
Pooled randomised trials put naproxen at a rate ratio of 0.93 for major vascular events, the only one of four drug groups with no excess. A pooled analysis of prescribing databases put its first-week heart-attack odds at 1.53, the highest of the five drugs it ranked.
The caveat · Database misses over-the-counter use
Both figures are relative, and neither set of authors supplies the baseline that would turn them into a personal number. The randomised trials used high, sustained, prescription-level doses in people with arthritis. The database analysis infers what people took from prescription records, so anything bought over the counter is invisible to it. A third pooled review of community databases put naproxen lowest of all, at 1.09.
What we don't know
Whether naproxen is the heart-safe painkiller is unsettled. Trials and prescribing databases disagree, and the databases disagree with each other, along study design rather than dose.