A Cardiologist Warns: 5 Types of Medications That Can Increase Heart Attack and Stroke Risk in Older People
Some medicines can affect blood pressure, heart rate, blood vessels, fluid balance, or blood clotting. These effects can be more important in older adults, particularly people who already have heart disease, high blood pressure, kidney problems, or a previous stroke.
This does not mean that these medicines are automatically unsafe or should be stopped. Many are useful and necessary when prescribed appropriately. The important issue is knowing about potential cardiovascular risks and discussing them with a healthcare professional.
1. Nonsteroidal Anti-Inflammatory Drugs (NSAIDs)
Common NSAIDs include medicines such as ibuprofen and naproxen. They are widely used for pain and inflammation.
Non-aspirin NSAIDs carry an FDA warning about an increased risk of serious cardiovascular events, including heart attack and stroke. The risk can occur relatively early and may increase with higher doses or longer use.
Older adults and people with existing cardiovascular or kidney problems may need particular caution.
2. Some Decongestants
Cold and allergy medicines containing decongestants such as pseudoephedrine or phenylephrine can constrict blood vessels and raise blood pressure.
This can be especially concerning for someone who already has high blood pressure or cardiovascular disease. The FDA specifically advises people with heart disease or high blood pressure to seek medical advice before using nasal decongestants.
Always check the active ingredients in combination cold medicines because the same ingredient can appear in several products.
3. Certain Prescription Stimulants
Prescription stimulants can increase heart rate and blood pressure. The FDA has warnings concerning serious cardiovascular complications, particularly when these medicines are misused or taken inappropriately.
When appropriately prescribed, the decision to use them depends on the person’s medical history, condition, dose, and other medicines.
4. Some Medicines That Can Raise Blood Pressure
Several medication classes can contribute to higher blood pressure in some people. The American Heart Association lists examples including NSAIDs, decongestants, systemic corticosteroids, certain antidepressants, atypical antipsychotics, and some hormonal medications.
A higher blood pressure does not automatically mean a heart attack or stroke will occur, but persistent hypertension is an important cardiovascular risk factor.
5. Aspirin — When Used Without Medical Guidance
Aspirin is different from the medications above because it can actually help prevent heart attacks and clot-related strokes in certain people with established cardiovascular disease.
However, taking daily aspirin without professional guidance is not appropriate for everyone. It can cause serious bleeding, including bleeding in the stomach or brain, and the balance between benefits and risks changes with age and medical history.
Therefore, someone who has been prescribed aspirin should not simply stop taking it because of a warning article. The decision should be made with their healthcare professional.
Why Older Adults Need Extra Medication Review
As people age, changes in kidney and liver function can affect how medicines are processed. Older adults are also more likely to take several medications at the same time, increasing the possibility of drug interactions.
A medication that was well tolerated years ago may therefore need to be reviewed as a person’s health, other medicines, or kidney and liver function changes.
Don’t Stop a Prescription Suddenly
One of the most important points is not to stop a prescribed medication simply because you read that it can affect the heart or blood vessels. Suddenly stopping certain medicines can itself cause problems.
Instead, make a complete list of prescription medicines, over-the-counter products, vitamins, and supplements and review it with a doctor or pharmacist. They can determine whether a particular medication, dose, combination, or alternative is appropriate.
The Bottom Line
The cardiovascular effects of medications depend on the specific drug, dose, duration of use, other medicines, and a person’s underlying health. NSAIDs and certain decongestants are particularly important examples for people with cardiovascular risk factors, while aspirin illustrates why a medication’s risks and benefits must be considered together.
A medication warning should be a reason for a professional medication review—not a reason to stop treatment on your own.
