Large-scale studies and cardiology guidelines (AHA/ACC 2022–2025 updates) show:
Regular NSAID use increases risk of heart attack by 20–50% (diclofenac up to 100% in some analyses)
Risk of heart failure hospitalization rises 30–100% depending on dose & duration
Increases blood pressure by 3–6 mmHg systolic on average — enough to push many seniors from “controlled” into “uncontrolled” hypertension
Higher risk of atrial fibrillation and sudden cardiac events
Kidney damage risk also jumps significantly (acute kidney injury, worsening CKD)Why NSAIDs Are Especially Risky After 60
Older blood vessels are already stiffer — NSAIDs reduce protective prostaglandins → blood vessels constrict → higher pressure & strain on heart
Fluid retention — NSAIDs block kidney prostaglandins → sodium & water retention → increased cardiac workload
Platelet effects — While low-dose aspirin protects, most NSAIDs block protective prostaglandins more than clotting ones → imbalance favors clots
Reduced kidney blood flow → worsens hypertension and heart strain
Highest-risk groups (cardiologists warn most strongly):
Already have heart failure, prior heart attack, stent, bypass, or arrhythmia
Have high blood pressure (even if controlled)
Take diuretics, ACE inhibitors, ARBs, or beta-blockers
