If you’re asking which medications can raise cardiovascular or stroke risk in older adults, there isn’t a single evidence-based list of exactly five drugs that is dangerous for everyone. Risk depends on the medication, dose, duration, existing heart disease, blood pressure, kidney function, and other medicines.
Five important categories to review with a clinician are:
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Non-aspirin NSAIDs — such as ibuprofen, naproxen, and diclofenac. These can increase the risk of heart attack and stroke, with risk potentially appearing early and increasing with higher doses or longer use. U.S. Food and Drug Administration+1
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Nasal decongestants — particularly products containing sympathomimetic ingredients such as pseudoephedrine or phenylephrine. They can raise blood pressure and heart rate, which is particularly concerning in people with hypertension or heart disease. U.S. Food and Drug Administration+1
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Aspirin when taken without an appropriate indication — aspirin can prevent cardiovascular events in certain people with established cardiovascular disease, but routine use isn’t appropriate for everyone and can cause serious bleeding, including bleeding in the brain. U.S. Food and Drug Administration+1
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Certain combinations of blood-thinning medicines — combining aspirin with anticoagulants such as warfarin or other blood thinners can substantially increase bleeding risk. Whether a combination is appropriate depends on the individual’s medical indication and should be determined by their clinician. U.S. Food and Drug Administration+1
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Some medicines that raise blood pressure or heart rate — this includes certain stimulant/sympathomimetic products. The cardiovascular implications can be more significant in people who already have hypertension or heart disease. U.S. Food and Drug Administration+1
Important: Don’t stop a prescribed medication abruptly because you’ve read that it can affect heart or stroke risk. The FDA specifically recommends that older adults discuss medication changes with their healthcare professional, because stopping or changing treatment can also be harmful. U.S. Food and Drug Administration
If you give me the names of the medications an older person is taking, I can explain which ones have cardiovascular or stroke warnings and what questions to discuss with their doctor.
