“5 medications that increase heart attack and stroke risk in older people” — what’s true?
This headline is too broad. Some medicines can increase cardiovascular risk in certain older adults, but that doesn’t mean they are universally dangerous or should be stopped.
Five medication groups worth discussing with a doctor or pharmacist are:
NSAID painkillers — such as ibuprofen, naproxen, and diclofenac. They can raise blood pressure and, particularly with higher doses or longer use, increase cardiovascular and kidney risks.
P
PubMed Central (PMC)
Certain antipsychotics — older adults with dementia have an increased risk of stroke and mortality when treated with antipsychotics. These drugs may nevertheless be appropriate for specific psychiatric conditions.
P
PubMed Central (PMC)
Aspirin when used for primary prevention — in many older adults who have never had a cardiovascular event, starting aspirin can produce more bleeding harm than cardiovascular benefit. This is very different from aspirin prescribed after a heart attack or stroke, where it may be important.
P
PubMed Central (PMC)
Certain diabetes medicines that cause fluid retention, such as pioglitazone, can be problematic in people with heart failure.
P
PubMed Central (PMC)
Some cardiovascular drugs can be inappropriate in specific heart conditions. For example, diltiazem and verapamil should generally be avoided in older adults with heart failure with reduced ejection fraction because they can worsen the condition.
P
PubMed Central (PMC)
Don’t stop medications because of a viral warning
The important question is why the medication was prescribed, what dose you’re taking, and what other conditions and medicines you have. A medication that is risky for one person may be highly beneficial for another.
If you’re concerned about a particular medicine, give me its name and dose, and I can explain its cardiovascular risks and what older adults should watch for.
P
Sources
