Many patients with arthritis take anti-inflammatory drugs to relieve pain and stiffness, for which they are very effective. A meta-analysis in the BMJ published earlier this year showed that rofecoxib was associated with the highest risk of myocardial infarction, and ibuprofen with the highest risk of stroke. Naproxen was considered to be the least harmful but the authors cautioned that none of these drugs could really be considered safe in the presence of cardiovascular disease. Balancing the risks and benefits of drugs and surgery is seldom straightforward. If you would like advice on how best to manage your symptoms, please get in touch.