What NSAID has a low GI risk and a high cardiovascular risk?

Naproxen is recognized for its low gastrointestinal (GI) risk while simultaneously presenting a higher cardiovascular risk compared to other nonsteroidal anti-inflammatory drugs (NSAIDs). This is primarily due to the drug's mechanism of action and its pharmacological properties.

Naproxen is a non-selective NSAID, which means it inhibits both cyclooxygenase-1 (COX-1) and cyclooxygenase-2 (COX-2) enzymes. While these enzymes are involved in the inflammatory process, COX-1 is also responsible for protecting the stomach lining. The lower GI risk associated with naproxen relative to other non-selective NSAIDs can be attributed to its pharmacokinetics, including its longer half-life and dosing regimen that may lead to less frequent dosing, thus reducing the gastric irritation tendency.

However, regarding cardiovascular risk, studies have indicated that naproxen may not be as safe as initially thought and carries a higher risk of cardiovascular events compared to some other NSAIDs, particularly in certain populations or when used long-term. This duality of effects — low GI risk coupled with a heightened cardiovascular risk — is essential in guiding treatment decisions for patients who require NSAID therapy, especially in those with pre