5 Medications Older Adults Should Discuss With Their Doctor About Heart and Stroke Risk
The headline “these 5 medications increase the risk of heart attack and stroke” needs some context. Medicines don’t affect everyone the same way, and several of the drugs below can be appropriate and beneficial when medically indicated. Risk depends on the specific medicine, dose, duration, and a person’s existing cardiovascular conditions.
1. Non-aspirin NSAID painkillers
Examples include ibuprofen, naproxen, and diclofenac. NSAIDs can increase the risk of heart attack and stroke, with risk tending to be greater at higher doses and with longer use. U.S. Food and Drug Administration+1
2. Certain decongestants
Cold medicines containing pseudoephedrine or other decongestants can raise blood pressure and may be a concern for people with hypertension or heart disease. Older adults should check the active ingredients in combination cold medicines. U.S. Food and Drug Administration+1
3. Certain JAK inhibitors
Medicines such as tofacitinib, baricitinib, and upadacitinib carry FDA warnings about serious cardiovascular events, including heart attack and stroke, particularly in certain higher-risk patients. U.S. Food and Drug Administration
4. Systemic corticosteroids
Drugs such as prednisone can affect blood pressure, blood glucose, fluid balance, and other cardiovascular risk factors, particularly when used for longer periods. Their benefits can nevertheless outweigh these risks when appropriately prescribed.
5. Aspirin when taken without medical guidance
This one is frequently misunderstood. Aspirin can reduce heart attack and clot-related stroke risk in certain people who already have cardiovascular disease, but routine daily aspirin isn’t appropriate for everyone. It can cause serious bleeding, including bleeding in the brain. U.S. Food and Drug Administration+1
⚠️ Don’t stop medication on your own
If you’re older and take several prescription or over-the-counter medicines, a medication review with a doctor or pharmacist can identify potentially unnecessary drugs, interactions, and safer alternatives. Aging can change how the body processes medicines and can increase the likelihood of drug interactions. U.S. Food and Drug Administration+1
The important message isn’t “avoid these five drugs.” It’s “make sure every medication you take has an appropriate benefit-to-risk balance for you.”
