Although many people may believe that over-the-counter medications are generally safer than stronger prescription drugs, research shows that there may still be risks for some people.
Certain common over-the-counter painkillers are associated with an increased risk of: high blood pressurestroke, heart attack.
NSAIDs (nonsteroidal anti-inflammatory drugs), which are used to reduce pain, fever, and inflammation, have been identified as the class of medications most associated with increased blood pressure. cardiovascular risk.
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“This is to reduce the production of certain chemicals called prostaglandins,” Dr. Mariam Dowza, an anesthesiologist at UNC Health in North Carolina, told FOX News Digital. “These chemicals are involved in inflammation, but they also play a role in other body functions, including influencing how you feel. blood vessels. ”
Fox News senior medical analyst Dr. Mark Siegel expressed similar sentiments about the potential risks of NSAIDs.
“It can cause high blood pressure, heart attacks and strokes through fluid retention and salt retention,” he told Fox News Digital. “This increases volume, puts strain on the heart, and increases blood pressure.”
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Common examples of NSAIDs include ibuprofen, naproxen, aspirin, diclofenac, indomethacin, and celecoxib.
A randomized trial found that ibuprofen caused the greatest increase in blood pressure, followed by naproxen and celecoxib.
“In general, the higher the dose and the longer the treatment, the more likely it is that blood pressure will increase,” said Jowza, who is also an associate professor in the UNC School of Medicine Department of Anesthesiology.
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NSAIDs may also increase stroke riskespecially with high doses and long-term use, the doctor added.
Diclofenac is associated with the highest cardiovascular risks, doctors warned. Ibuprofen can also raise blood pressure and is associated with an increased risk of heart attack and stroke, but not as high as diclofenac. Although naproxen has lower cardiovascular risks than ibuprofen and diclofenac, it is not completely risk-free.
“The practical conclusion is that diclofenac is generally the least preferred option for patients at high cardiovascular risk. all NSAIDs It should be used at the lowest effective dose and for the shortest period of time,” Dr. Nayan Patel, a pharmacist and founder of Oro Wellness in Southern California, told Fox News Digital.
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Aspirin is an exception. Although it is an NSAID, it actually reduces the risk of blood clots when taken prophylactically in low doses under medical supervision. However, high doses may increase bleeding risk and blood pressure.
Non-NSAID painkillers It is often used for everyday pain, headaches, and fever, but not for swelling. Medical experts say they primarily act on pain signals in the brain, rather than inflammation.
Jowza said the most common non-NSAID painkiller, acetaminophen, has also been associated with an increase in blood pressure, although to a lesser extent.
“Although acetaminophen was once thought to have little or no cardiovascular effects, recent evidence suggests that it may increase blood pressure, especially when used in high doses and over long periods of time,” she said, emphasizing the importance of: blood pressure monitoring. “Its effect on stroke risk is less clear.”
Doctors say the groups most at risk are those with pre-existing health conditions such as high blood pressure, previous stroke or heart disease, diabetes or kidney problems.
“These groups are also more likely to experience NSAID-related fluid retention and destabilization of blood pressure control,” Patel said.
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Cardiovascular risk is generally higher in people Over 75 years oldDoctors agreed.
“Baseline cardiovascular risk increases with age, and renal reserve tends to decline, so age greatly amplifies risk,” Patel said. “NSAIDs can destabilize blood pressure control and complicate safety because older adults are more likely to be taking antihypertensive, diuretic, antiplatelet, and anticoagulant medications.”
People who are experiencing chest pain, shortness of breathif you experience sudden weakness or numbness, severe headaches, confusion, slurred speech, or changes in vision, you should seek immediate medical attention, Jousa advised.
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“These symptoms may indicate a heart attack or stroke,” she warned. “Other concerning symptoms that may not progress as rapidly, such as new swelling in the foot, should also prompt medical attention.”
“Patients should also seek medical advice if they notice signs of fluid retention or stress on the kidneys, such as a sudden increase in blood pressure, swelling in the legs, rapid weight gain over several days, decreased urine output, or worsening shortness of breath,” it added.
For those at high risk, Patel recommends non-NSAID approaches whenever possible.
“For many patients, this means starting with: Non-drug strategy “If medication is required, acetaminophen is generally preferred over oral NSAIDs from a cardiovascular perspective, but regular use should be monitored in people with high blood pressure,” he told Fox News Digital.
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For localized joint and muscle pain, he said topical NSAIDs could provide “meaningful relief” at “much lower” risk.
“Overall, pain management high risk patients Emphasis should be placed on targeted therapy, conservative dosing, and close blood pressure monitoring. ”
The doctors stressed that while the overall risk for people taking OTC painkillers short-term is “very low,” the risk increases with long-term, high-dose use.
“I wouldn’t hesitate to give it occasionally to someone who doesn’t have a history of heart attacks or strokes and is at low risk,” Joza said. “I also think short-term use in patients with well-controlled diabetes and hypertension is acceptable.”
For patients taking NSAIDs, doctors suggested using “guardrails” such as regular blood pressure and kidney function tests and dosage limits to make treatment as safe as possible.
Patel also agreed with most people. healthy personoccasional NSAID use “does not pose significant cardiovascular risks.”
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He acknowledged to Fox News Digital that the “main concerns are with repeated or chronic use, high doses, and use in people with underlying cardiovascular, renal, and blood pressure conditions.”
“However, large population studies have shown that cardiovascular events can occur early after initiation of NSAIDs, especially at high doses, so even short-term use should be approached with caution in high-risk patients.”
