Harvard Heart Letter

Advice on using painkillers safely

Reduce your risk of a heart attack, stroke, or death.

Nonsteroidal anti-inflammatory drugs (NSAIDs) are widely used for relieving pain, reducing inflammation, and calming fevers. Some low-dose NSAIDs are available over the counter—for example, ibuprofen (Advil, Motrin) and naproxen (Aleve). This leads people to believe they are completely safe. But, since NSAIDs were first introduced, there were theoretical reasons to believe they might (infrequently) cause heart problems. This concern was amplified in 2004 when the prescription NSAID rofecoxib (Vioxx) was found to increase the risk of heart attack and stroke. Since then, Vioxx and several related NSAIDs have been taken off the market.

Other studies have found that all existing NSAIDs except aspirin pose some risk for people with heart disease. A study published in The American Journal of Medicine in January 2012 found that NSAIDs can raise blood pressure and interfere with blood pressure–lowering medications. A different study, published in Circulation on Oct. 16, 2012, found that among people who experienced a heart attack and regularly took NSAIDs after the attack, the risk of having a second heart attack increased by 41% over the next five years, and the risk of dying increased by 63% over the next five years.

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