Cardiovascular risk	Gastrointestinal risk*	Recommendation
		American College of Gastroenterology 22	Canadian Association of Gastroenterology 24
Low	Low	NSAID	NSAID
	Moderate	NSAID plus PPI or misoprostol (Cytotec)	—
	High	Alternative therapy if possible, or COX-2 inhibitor plus PPI or misoprostol	COX-2 inhibitor plus PPI
High	Low	Naproxen plus PPI or misoprostol	Naproxen
	Moderate	Naproxen plus PPI or misoprostol	—
	High	Avoid NSAID and COX-2 inhibitor; alternative therapy	Gastrointestinal concern is greater than cardiovascular concern: COX-2 inhibitor plus PPI
			Cardiovascular concern is greater than gastrointestinal concern: naproxen plus PPI