❤️ A Cardiologist Warns: 5 Medication Types That Can Raise Heart Attack or Stroke Risk in Older Adults

The headline “these 5 medications cause heart attacks and strokes” is too broad. Medications can be lifesaving, and the risk depends on the person’s medical conditions, dose, duration, and other medicines they take.

Older adults are also more vulnerable to medication side effects and drug interactions because age-related changes can affect how medicines are processed by the body. U.S. Food and Drug Administration+1

Here are five medication groups that deserve particular attention.

1. 💊 NSAID Painkillers

Common examples include:

• Ibuprofen
• Naproxen
• Diclofenac
• Celecoxib

Nonsteroidal anti-inflammatory drugs (NSAIDs) can increase cardiovascular risk in some people, particularly with higher doses or prolonged use. They can also raise blood pressure and cause fluid retention.

Older adults with heart failure, kidney disease, or cardiovascular disease may need particular caution. The American Geriatrics Society recommends avoiding NSAIDs in older adults with symptomatic heart failure and using them cautiously in certain other circumstances. PubMed Central (PMC)+1

That doesn’t mean everyone should stop taking an NSAID. If you need one regularly, ask your doctor whether it remains appropriate.

2. 🩸 Aspirin When Used Without a Clear Medical Reason

Aspirin is complicated because it can prevent heart attacks and ischemic strokes in selected patients, while also increasing bleeding risk.

For some older adults who have already had a heart attack or certain types of stroke, aspirin may provide important protection.

But using daily aspirin for primary prevention—trying to prevent a first cardiovascular event—may not be appropriate for many older adults because the bleeding risk can outweigh the benefit. The FDA emphasizes that aspirin should be used for cardiovascular prevention according to individualized medical advice. U.S. Food and Drug Administration+1

Never stop prescribed aspirin without discussing it with your doctor.

3. 💗 Certain Decongestants

Some cold and allergy products contain oral decongestants such as pseudoephedrine or phenylephrine.

These medicines can raise blood pressure and heart rate in susceptible people.

This can be particularly relevant if an older adult already has:

• Uncontrolled high blood pressure
• Heart disease
• An abnormal heart rhythm
• Other cardiovascular problems

Always check the active ingredients in combination cold medicines. Several products may contain the same decongestant, making accidental excessive dosing possible.

4. 🧠 Certain Antipsychotic Medications

Examples include:

3. 💗 Certain Decongestants

This can be particularly relevant if an older adult already has:

• Uncontrolled high blood pressure
• Heart disease
• An abnormal heart rhythm
• Other cardiovascular problems

4. 🧠 Certain Antipsychotic Medications

Examples include:

• Risperidone
• Olanzapine
• Quetiapine
• Haloperidol

These medications have legitimate and sometimes essential uses. They should not be portrayed as medications that simply “cause strokes.”

However, in older adults with dementia, antipsychotics are associated with increased risks including stroke, cognitive decline, and mortality. The AGS Beers Criteria therefore recommends avoiding them for behavioral symptoms of dementia unless specific circumstances justify their use. Cleveland Clinic+1

If someone is taking an antipsychotic, the decision to continue it should be individualized with their prescriber.

5. 💊 Certain Diabetes Medications in People With Heart Failure

Some medications in the thiazolidinedione (TZD) class, particularly pioglitazone, can cause fluid retention and worsen heart failure.

This doesn’t mean they directly cause a heart attack or stroke in everyone taking them.

The concern is particularly important for older adults who already have heart failure. The 2023 Beers Criteria recommends avoiding these medicines in symptomatic heart failure and using caution in certain other circumstances. UConn Health+1

⚠️ The Bigger Issue May Be Medication Combinations

Sometimes the danger isn’t one particular medication.

Older adults frequently take several prescriptions, over-the-counter medicines, and supplements simultaneously. Age-related changes in the kidneys and liver can also affect how medications are eliminated. U.S. Food and Drug Administration

That’s why a complete medication review is so valuable.

Bring your doctor or pharmacist a list of everything you take, including:

• Prescription medicines
• Over-the-counter painkillers
• Cold and allergy medicines
• Vitamins
• Herbal supplements
• Sleep aids
• Occasional medications

🚫 Don’t Stop Heart or Blood-Pressure Medication on Your Own

This is extremely important.

A scary headline about a medication doesn’t mean you should suddenly discontinue it.

Stopping some cardiovascular medications abruptly can itself be dangerous. Instead, ask:  “Do I still need this medication, and is the dose and combination appropriate for me at my age and with my other health conditions?”

Your doctor or pharmacist can determine whether a medication should be continued, adjusted, replaced, or gradually discontinued.

🚨 Know the Signs of a Heart Attack or Stroke

Medication concerns should never distract from recognizing an actual emergency.

Call emergency medical services immediately for symptoms such as:

• New or severe chest pressure
• Severe shortness of breath
• Fainting
• Sudden weakness or numbness, especially on one side
• Sudden facial drooping
• Sudden difficulty speaking
• Sudden loss of vision
• Sudden severe trouble walking or maintaining balance

Don’t wait for symptoms to disappear.

🌟 The Bottom Line

There isn’t a universal list of five medications that “cause heart attacks and strokes” in older people.

The more accurate message is that certain medications—including some NSAIDs, inappropriate aspirin use, certain decongestants, antipsychotics in specific older populations, and some diabetes medicines in people with heart failure—can create cardiovascular concerns in particular circumstances. PubMed Central (PMC)+1

For older adults, the safest strategy is regular medication review rather than abruptly stopping medications. A medication that is risky for one person may be exactly the right treatment for another.