What naproxen spares your heart it costs your stomach
In pooled trials it was the only drug group with no excess of major vascular events, at 0.93, and carried the highest rate of serious upper-gut complications, 4.22.
What the study found
Naproxen's vascular record comes with the worst gut record
In pooled randomised trials naproxen was the only one of four drug groups with no excess of major vascular events, at a rate ratio of 0.93. In those same trials it carried the highest rate of serious upper-gut complications, 4.22 against placebo, with ibuprofen just behind at 3.97.
The caveat · High daily doses in arthritis
These were high, sustained, prescription-level doses in people with arthritis, not occasional tablets. Every regimen studied raised upper-gut complications, so this is a ranking inside a class that all carried the risk, not a safe option beside a risky one. Heart failure risk was roughly doubled by every drug in the analysis, naproxen included.