5 medication categories that deserve particular attention
1. Nonsteroidal anti-inflammatory drugs (NSAIDs)
Common examples include ibuprofen, naproxen, diclofenac, and celecoxib.
NSAIDs can increase the risk of heart attack and stroke, and the risk can occur relatively early in treatment and increase with higher doses or longer use. They can also cause gastrointestinal bleeding and kidney problems.
This doesn’t mean an older person can never use an NSAID. The decision depends on the individual’s cardiovascular, kidney, gastrointestinal, and bleeding risks.
2. Nasal decongestants
Some cold and allergy medicines contain decongestants that can raise blood pressure and heart rate. This is particularly relevant for people who already have heart disease or hypertension. The FDA specifically advises people with heart disease or high blood pressure to seek medical advice before using certain nasal decongestants.
The important point is to check the active ingredients, because a product marketed simply as a “cold medicine” may contain a decongestant.
3. Aspirin when taken without an appropriate indication
Aspirin is complicated because it can reduce clot-related heart attacks and strokes in people with established cardiovascular disease, but it can also cause serious bleeding, including gastrointestinal and brain bleeding.
Therefore, an older adult shouldn’t start daily aspirin simply because they have reached a certain age. Whether aspirin is appropriate depends on their medical history and overall cardiovascular and bleeding risk.
If a doctor has prescribed aspirin after a heart attack, stroke, stent, or other cardiovascular condition, don’t stop it without discussing it with the prescriber.
4. Medicines that can significantly raise blood pressure or affect heart rhythm
Several medication classes can potentially affect cardiovascular risk through blood-pressure elevation, fluid retention, electrolyte changes, or effects on heart rhythm. The risk varies substantially between individual drugs.
This is why reviewing the entire medication list—including over-the-counter products and supplements—is often more useful than focusing on a single “dangerous” medication.
5. Certain combinations of medications
Sometimes the problem isn’t one medication at all. Polypharmacy—taking multiple medicines—can increase the chance of drug-drug and drug-condition interactions. The American Heart Association notes that polypharmacy is particularly common among people with cardiovascular disease and is associated with more adverse drug events and hospitalizations
