Over-the-counter (OTC) pain relievers are in practically everyone’s medicine cabinet. They’re a go-to for aches and pains and work well for most people.
But did you know that these medications can affect your heart, and that people with cardiovascular disease should proceed with caution?
“It's something many people don't realize — common over-the-counter pain relievers, specifically NSAIDs like ibuprofen and naproxen, can raise your risk of heart attack, heart failure, stroke, and worsen blood pressure,” said Joseph Danavi, DO, FACC, a cardiologist with Midwest Cardiovascular Institute at Endeavor Health Elmhurst Hospital.
“These medications are not only found in over-the-counter pain relievers but are also commonly included in combination products for symptoms like congestion, headache, and fever, such as cold, flu, and sinus medications," Dr. Danavi said.
"Anyone with heart or kidney problems, or risk factors like high blood pressure or diabetes, should take a close look at the label and check with their doctor before using these medications. In many cases, safer options like acetaminophen may be a better choice. But the right approach really depends on your overall health profile.”
The most common OTC pain medications fall into two categories: nonsteroidal anti-inflammatory drugs (NSAIDs) — such as aspirin, ibuprofen (Advil, Motrin) and naproxen (Aleve) — and acetaminophen (Tylenol).
NSAIDs
NSAIDs can interfere with the function of blood vessels and kidneys. More specifically, NSAIDs can:
- Raise blood pressure
- Cause fluid retention
- Reduce the effectiveness of heart medications
- Increase the risk of heart attack or stroke, especially in people with existing heart conditions
The Food and Drug Administration has warned about the increased risk of heart attack or stroke associated with NSAIDs, particularly when used at high doses or for long periods.
For years, physicians recommended some adults take an aspirin a day in late middle age to reduce their risk of a heart attack or stroke. That guidance has changed, and aspirin is no longer recommended for people who have no history of heart attack or stroke.
Aspirin, a blood thinner, can help prevent heart attacks and stroke (also known as cardiovascular disease) by preventing blood clots from forming in blood vessels that carry blood to the heart and brain. It can also increase the risk of internal bleeding, a risk that increases with age.
Acetaminophen
Acetaminophen is not an NSAID and does not carry the same level of cardiovascular risk. However, excessive use, especially in people with high blood pressure, can still pose indirect risks. For example, some studies suggest that long-term, high-dose acetaminophen use may also increase blood pressure in certain individuals, although the evidence is less clear than NSAIDs.
If you have high blood pressure, heart disease, kidney problems, or have had a stroke, you should talk to your doctor before using NSAIDs. Even healthy individuals should use them cautiously and follow label instructions closely.
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