Medications That May Increase Heart Attack or Stroke Risk in Some Older Adults
Older adults are more likely to take several medications at once, and age-related changes in kidney and liver function can affect how medicines work. Some medications can also raise blood pressure, increase clotting risk, or increase the chance of cardiovascular complications in certain people.
1. Certain NSAID Pain Relievers
Nonsteroidal anti-inflammatory drugs (NSAIDs), including medicines such as ibuprofen and naproxen, can increase the risk of serious cardiovascular events, including heart attack and stroke. Risk can be greater with higher doses and longer use.
2. Some Decongestants
Decongestants such as pseudoephedrine and phenylephrine can constrict blood vessels and raise blood pressure. They may be particularly concerning for people with high blood pressure or cardiovascular disease.
3. Certain JAK Inhibitors
Some medicines in the JAK-inhibitor class, including tofacitinib, baricitinib, and upadacitinib, carry FDA warnings about serious heart-related events, stroke, and blood clots in certain patients. Individual risk depends on factors such as age, smoking history, and cardiovascular history.
4. Aspirin When Used Without Medical Guidance
Aspirin is different from medications that simply increase cardiovascular risk: it can reduce heart attack and clot-related stroke risk in some people. However, it can also cause serious bleeding, including bleeding in the brain or stomach. Whether daily aspirin is appropriate depends on the individual’s medical history.
5. Medicines That Raise Blood Pressure
Several medication classes can increase blood pressure in some people, including certain antidepressants, corticosteroids, atypical antipsychotics, decongestants, and NSAIDs. For someone already at risk of cardiovascular disease, an increase in blood pressure can be important.
Don’t Stop Prescribed Medication on Your Own
A medication appearing on a risk list does not mean it should automatically be stopped. Many of these medicines provide important benefits, and the risks depend on the person’s condition, dose, duration of treatment, and other medications.
Bottom line: Older adults should periodically review all prescription medicines, over-the-counter drugs, and supplements with a doctor or pharmacist. This is especially important when taking multiple medications or when there is a history of high blood pressure, heart disease, stroke, or blood clots.
