how does ibuprofen increase stroke risk if it thins the blood?
In: Biology
There are 2 main types of stroke. One comes from a blood clot in the brain. Ibuprofen has a tendency to thin the blood. A stroke from a blood clot is not too much concern if taking ibuprofen, but the second main type of stroke is from a blood vessel bursting in the brain and causing a brain bleed. If the blood is already thin from taking Ibuprofen or aspirin, the ruptured blood vessel will continue to bleed causing a more severe stroke.
This is complicated: drugs like ibuprofen have many effects, and some of these effects may reduce blood clotting, and some of the effects may increase blood clotting.
Specifically, NSAIDs like ibuprofen inhibit (among many, many other effects) two enzymes: cyclooxygenase-1 and cyclooxygenase-2. (COX-1 and COX-2). I don’t want to get too specific in ELI5, but high-level COX-1inhibiton reduces blood clotting, and COX-2 inhibition increase blood clotting. The balance between these two things will determine whether a particular NSAID will increase or decrease the risk of clotting events (stroke, heart attack, blood clots in the legs or chest).
Aspirin decreases these risks overall, whereas most other NSAIDs (ibuprofen, naproxen, and so forth) increase these risks.
Well, it makes the blood thinner and can also cause high blood pressure. Both of those together are a recipe for bleeding at weak points in blood vessels, and if that happens in your brain, you’re on a one-way train to stroke town.
Because many people at risk of stroke take aspirin, which effectively reduces their risk by inhibiting the aggregation behavior of platelets in the blood that causes strokes and similar conditions. Ibuprofen directly counteracts that effect, which can be dangerous to at-risk individuals who take both aspirin and ibuprofen (or any other NSAID)
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