A Cardiologist Warns: These 5 Medications Can Increase the Risk of Heart Attack and Stroke in Older People
The headline needs some context: medications aren’t automatically dangerous simply because someone is older. Risk depends on the drug, dose, duration, medical history, and other medicines being taken. Older adults are also more vulnerable to medication interactions because kidney and liver function can change with age. U.S. Food and Drug Administration+1
1. Nonsteroidal Anti-Inflammatory Drugs (NSAIDs)
Examples include ibuprofen, naproxen, diclofenac, and similar anti-inflammatory pain medicines.
The FDA warns that non-aspirin NSAIDs can increase the risk of serious cardiovascular events, including heart attack and stroke. The risk can occur relatively early in treatment and may increase with higher doses and longer use. FDA Access Data+1
This is particularly important for older adults and people who already have cardiovascular disease, high blood pressure, or a previous heart attack or stroke.
Don’t stop a prescribed NSAID without discussing it with your clinician.
2. Decongestants
Cold and sinus medicines containing pseudoephedrine or phenylephrine can constrict blood vessels and raise blood pressure. This can be particularly concerning for people with hypertension or cardiovascular disease. www.heart.org
Check the active ingredients of combination cold medicines because a decongestant can be hidden in a product marketed simply for “cold,” “flu,” or “sinus” symptoms.
3. Certain JAK Inhibitors
Some medicines in the JAK inhibitor class, including tofacitinib, baricitinib, and upadacitinib, carry FDA warnings concerning serious heart-related events, blood clots, and death in certain populations. The FDA’s strongest warning is particularly relevant to people with cardiovascular risk factors and older adults. U.S. Food and Drug Administration+1
These are prescription medicines used for conditions such as rheumatoid arthritis and other inflammatory diseases. Their risks have to be weighed against their benefits for the individual patient.
4. Aspirin When Used Without Medical Guidance
This one is more complicated. Aspirin can reduce the risk of another heart attack or certain clot-related strokes in people with established cardiovascular disease, so it can be an important medication when appropriately prescribed. U.S. Food and Drug Administration+1
However, taking daily aspirin for prevention without discussing it with a healthcare professional can cause serious bleeding, including gastrointestinal or brain bleeding. The FDA specifically emphasizes that daily aspirin isn’t appropriate for everyone. U.S. Food and Drug Administration+1
Therefore, don’t start or stop daily aspirin based on an online list.
5. Medicines That Raise Blood Pressure or Interact With Cardiovascular Treatment
Some medications—including certain OTC products and combinations—can raise blood pressure or interfere with other cardiovascular medicines. The problem is often the combination of medicines rather than one drug alone.
For example, the FDA notes that ibuprofen can interfere with aspirin’s cardiovascular protective effect depending on how the medicines are taken. U.S. Food and Drug Administration
The Most Important Point
The headline shouldn’t be interpreted as “older people should avoid these five medications.” Some of these drugs can be appropriate and beneficial when prescribed for the right person.
If you’re over 60 and taking several medicines, have your doctor or pharmacist review your complete medication list, including over-the-counter painkillers, cold medicines, vitamins, and supplements. Older adults have a greater risk of drug interactions, and medicines that were previously well tolerated may sometimes need adjustment as the body changes with age. U.S. Food and Drug Administration
Never stop a prescribed heart, blood-pressure, blood-thinning, or other medication abruptly without medical advice.
