Thank you for this article. Adding to the kidney issues, the heart and stomach are also very important to consider. A few points to discuss. One is that you are right, the newest research is saying that COX-2 selective inhibitors are not shown to increase heart attacks (at least Celebrex) in relation to non-selective types. However, Vioxx (COX 2- selective) was taken off the market, due to what is at least debatable now, significant heart mortality increase. There may have been confounding variables in this but one study found that Vioxx doubled the risk of myocardial infarction and the company voluntarily took it off the market. The VIGOR study found a 14% increase in Aleve. I don't fully have confidence in any of these studies at the moment because they are so contradictory even though they are very large studies with much thought and design. Important to note that I think all NSAIDS whether COX 1 or 2 should be treated with caution in those with coronary artery disease. COX 1 and 2 are both found in the vasculature of the heart.

Another note on tylenol: in basic terms it works mostly on the central nervous system. We don't fully understand this mechanism of action and why it doesn't work systemically (not an anti-inflammatory)...One theory is that the drug is broken down peripherally. So I would not expect any cardiovascular effects from it. So it probably modulates (decreases) pain by acting centrally and regulates temperature centrally.