A Cardiologist Warns: 5 Medication Types That Can Increase Heart Attack or Stroke Risk in Older Adults
Detail
There isn’t a universal list of five medicines that every older person should avoid. The cardiovascular risk depends on the drug, dose, duration, existing heart disease, blood pressure, kidney function, and other medicines being taken. Older adults are also more susceptible to medication interactions as kidney and liver function can change with age. U.S. Food and Drug Administration+1
1. Non-Aspirin NSAIDs
Examples include ibuprofen, naproxen, diclofenac, and celecoxib.
These medicines can increase the risk of heart attack and stroke, with risk potentially appearing early in treatment and increasing with higher doses or longer use. People with existing cardiovascular disease may have greater baseline risk. U.S. Food and Drug Administration+1
Important: Don’t assume an over-the-counter painkiller is automatically safe simply because it’s sold without a prescription.
2. Certain Decongestants
Oral nasal decongestants can raise blood pressure and heart rate, which may be particularly concerning for people with hypertension or cardiovascular disease. FDA guidance recommends checking with a doctor before using decongestants if you have heart disease or high blood pressure. U.S. Food and Drug Administration+1
3. Stimulant-Containing Medicines
Some stimulant medications can increase heart rate and blood pressure. Their safety depends heavily on the individual, dose, and medical condition, so they shouldn’t be stopped or changed without professional guidance.
4. Aspirin When Used Without Medical Advice
This one is often misunderstood. Aspirin isn’t simply a “dangerous heart medicine.” For people who have already had certain heart attacks or strokes or have established cardiovascular disease, prescribed aspirin can reduce the risk of another event.
But taking daily aspirin for primary prevention isn’t appropriate for everyone, particularly older adults at increased bleeding risk. Aspirin can cause serious gastrointestinal or brain bleeding. U.S. Food and Drug Administration+1
5. Medicines or Combinations That Unintentionally Raise Blood Pressure
Some OTC products and medication combinations can increase blood pressure or interfere with cardiovascular treatment. This is particularly important when someone takes multiple prescriptions plus OTC pain, cold, allergy, or herbal products.
Older adults have a higher risk of medication interactions because the body may process medicines differently with age. U.S. Food and Drug Administration+1
What You Should Do
Don’t stop any prescribed medication because of a headline. Instead:
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Have your pharmacist or doctor review your complete medication list.
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Include OTC medicines, vitamins, supplements, and herbal products.
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Ask whether an NSAID or decongestant is appropriate for you.
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Check your blood pressure regularly if you’re at risk.
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Use the lowest effective dose of OTC medicines for the shortest appropriate time.
🚨 Seek Emergency Care
Get emergency help for chest pressure or pain, sudden difficulty breathing, fainting, or sudden weakness/numbness on one side, facial drooping, trouble speaking, or sudden vision loss.
Bottom line: The biggest evidence-based concern on this list is non-aspirin NSAIDs, while decongestants and some stimulant-containing medicines can also be problematic for people with cardiovascular risk. Aspirin is different—it can be beneficial for certain patients but harmful when taken unnecessarily. U.S. Food and Drug Administration+1
