Some common pain medicines may increase the risk of heart attack and stroke, especially with higher doses or longer use. Learn what adults over 60 should know.
Cardiologists Warn: This Common Medication May Increase Heart Risks After Age 60
As we get older, medications that once seemed harmless can require more careful consideration. One important example is nonsteroidal anti-inflammatory drugs (NSAIDs), a group of common pain relievers used for arthritis, muscle aches, headaches, and other painful conditions.
Examples include ibuprofen, naproxen, diclofenac, and celecoxib. Research and regulatory warnings indicate 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 or longer use.
Why Can NSAIDs Affect the Heart?
NSAIDs work by reducing substances called prostaglandins that contribute to pain and inflammation. However, these substances also have important effects on blood vessels, kidneys, and fluid balance.
In some people, NSAIDs can contribute to:
- Increased blood pressure
- Fluid retention
- Worsening heart failure
- Changes in kidney function
- Increased cardiovascular risk
These effects may be particularly important in older adults, who are more likely to have high blood pressure, kidney disease, diabetes, or existing cardiovascular disease.
1. Ibuprofen
Ibuprofen is available without a prescription in many countries and is commonly used for short-term pain and inflammation.
Although occasional use may be appropriate for many people, cardiovascular risk can become more concerning with higher doses or prolonged use. Some regulatory guidance specifically highlights cardiovascular concerns with high-dose ibuprofen.
2. Naproxen
Naproxen is another commonly used NSAID. It is sometimes considered to have a comparatively favorable cardiovascular profile among traditional NSAIDs, but that does not mean it is risk-free.
It can still cause gastrointestinal bleeding, kidney problems, fluid retention, and other complications, particularly in older adults or people taking certain medications.
3. Diclofenac
Diclofenac deserves particular attention because evidence has associated it with increased cardiovascular risk. It is used for conditions such as arthritis and other inflammatory pain.
People with cardiovascular disease or significant cardiovascular risk factors should discuss whether diclofenac is appropriate with their healthcare professional.
4. Celecoxib
Celecoxib belongs to a subgroup of NSAIDs called COX-2 inhibitors. It may have advantages for some patients, but it can still carry cardiovascular risks.
The appropriate medication and dose depend on an individual’s medical history, cardiovascular risk, kidney function, and other medicines.
Why Age 60 Matters
Age itself does not mean that everyone over 60 should avoid NSAIDs. However, older adults are more likely to have medical conditions and medication combinations that increase the potential for complications.
For example, NSAIDs may increase blood pressure and can cause fluid retention. They can also interact with medications commonly prescribed for cardiovascular conditions.
This is why medication decisions should be individualized rather than based on age alone.
People Who Should Be Especially Careful
Talk with a healthcare professional before regularly using NSAIDs if you have:
- A history of heart attack or stroke
- Heart failure
- High blood pressure
- Kidney disease
- Diabetes
- A history of stomach ulcers or gastrointestinal bleeding
- Other significant cardiovascular risk factors
The risk of complications can also increase when NSAIDs are combined with certain medicines, including aspirin, anticoagulants, antiplatelet drugs, corticosteroids, or some blood-pressure medications.
What About Aspirin?
Aspirin is different from non-aspirin NSAIDs and is often prescribed specifically to prevent cardiovascular events in people who already have cardiovascular disease.
However, starting daily aspirin after age 60 solely to prevent a first heart attack or stroke is not automatically recommended. Bleeding risk increases with age, and the decision should be individualized. Mayo Clinic notes that some guidelines recommend against starting aspirin for primary prevention at age 60 or older, while recommendations can vary depending on the individual.
If you already take prescribed aspirin because you have had a heart attack, stroke, or certain cardiovascular procedures, do not stop it without speaking with your healthcare professional.
How to Reduce Potential Risk
If an NSAID is necessary, healthcare professionals generally aim to use the lowest effective dose for the shortest appropriate period.
Depending on the type and cause of pain, other approaches may sometimes be considered, such as physical therapy, hot or cold therapy, topical treatments, or other medications.
Do not switch medications simply because of information in an online article. A pharmacist or doctor can help determine which option is safest for you.
Know the Warning Signs
Seek emergency medical attention if you develop possible symptoms of a heart attack or stroke, such as:
- Chest pressure or pain
- Severe shortness of breath
- Sudden weakness or numbness, particularly on one side
- Sudden difficulty speaking
- Sudden confusion or severe dizziness
The FDA specifically advises patients to seek immediate medical attention for symptoms suggestive of heart attack or stroke while taking NSAIDs.
Final Thoughts
NSAIDs can provide valuable relief from pain and inflammation, but they are not completely risk-free. For adults over 60, particularly those with cardiovascular disease or other health conditions, regular NSAID use deserves careful consideration.
The key is not to assume that every pain reliever is dangerous—or that everyone over 60 must avoid these medicines. Instead, discuss your individual risks, medications, dose, and duration of treatment with a healthcare professional.
Important: This article provides general health information and is not a substitute for personalized medical advice. Do not stop a prescribed medication without discussing it with your doctor or pharmacist.