Aspirin and ibuprofen: potential mediators of the cardiovascular risk due to smoking?

BACKGROUND AND OBJECTIVES Smokers have elevated C-reactive protein (CRP), an indicator of systemic inflammation and a marker for increased risk for cardiovascular disease (CVD). This study investigated among smokers the relationship between CRP and use of the anti-inflammatories aspirin and ibuprofen. METHODS Data from adults (>17 years) collected in the National Health and Nutrition Examination Survey (NHANES III) was analyzed (n = 8,850). Regression models were used to determine the independent relationship between aspirin and ibuprofen use and elevated CRP, controlling for demographics, body mass index, history of CVD, and health status. RESULTS Frequency of use of aspirin and ibuprofen among "ever smokers," a population that includes current smokers and quitters, was associated with a decreased likelihood of having elevated CRP. Ever smokers with low frequency of use of either aspirin or ibuprofen had a lower likelihood of having elevated CRP similar to that for "never smokers." In adjusted relationships, aspirin use was not significantly related to elevated CRP, while low use of ibuprofen had decreased odds of having elevated CRP compared to no use. CONCLUSIONS These preliminary findings from a nationally representative survey suggest that among patients refractory to smoking cessation interventions, use of ibuprofen may be useful to decrease CVD risk.