Millions rely on over-the-counter nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen (Advil, Motrin) and naproxen (Aleve) for headaches, muscle aches, and arthritis.
These popular pain relievers are convenient and effective—but growing evidence shows they can raise the risk of heart attack, stroke, and other cardiovascular problems, especially with long-term or high-dose use.
The Evidence: What Studies Show
The FDA strengthened warnings in 2015, stating NSAIDs increase heart attack and stroke risk—even in the first weeks of use—and the danger rises with longer duration or higher doses. A large 2017 meta-analysis found current NSAID use linked to a 20–50% higher risk of heart attack.
Recent 2024–2025 reports reaffirm this: Ibuprofen and diclofenac carry higher risks than naproxen, which some studies suggest is slightly safer (though still not risk-free). Those with existing heart disease, high blood pressure, or risk factors face the greatest threat.
How NSAIDs Affect the Heart
NSAIDs block enzymes (COX-1 and COX-2) that reduce pain and inflammation but also protect the heart by regulating blood pressure, clotting, and vessel function. This can lead to:
- Higher blood pressure
- Fluid retention
- Increased clotting risk
- Reduced protective prostaglandins in arteries
Who Should Be Most Cautious?
- People with heart disease, previous heart attack/stroke
- Those over 65
- Smokers or with diabetes/high cholesterol
Safer Alternatives
For occasional pain, acetaminophen (Tylenol) is generally heart-safer (though check liver limits). Non-drug options: Ice/heat, physical therapy, or topical NSAIDs.
NSAIDs remain valuable for many, but use the lowest dose for the shortest time. Always consult your doctor if at risk—your heart health matters!