Heart Surgeon Explains: How Common Medications Can Affect Heart Health in Older Adults

As we get older, medications can become an important part of everyday life. Many older adults take prescriptions for blood pressure, cholesterol, diabetes, arthritis, sleep problems, or other chronic conditions. Some medicines can protect the heart and reduce the risk of serious cardiovascular problems—but others, including certain common over-the-counter products, can affect blood pressure, fluid balance, heart rhythm, bleeding risk, or how other medications work.

That doesn’t mean older adults should be afraid of medication. The goal is not to stop necessary medicines; it is to make sure every medication is appropriate, monitored, and taken correctly.

Aging can change how the body absorbs, processes, and eliminates medicines. The liver and kidneys may work differently with age, potentially changing how long certain drugs remain in the body. Older adults are also more likely to take several medications at once, increasing the possibility of drug interactions.

Here is what older adults and their families should know about some common medication categories and heart health.

Why Medication Effects Can Change With Age

A medication that was well tolerated years ago may not affect the body in exactly the same way later in life.

Age-related changes can influence medication absorption, distribution, metabolism, and elimination. Kidney and liver function are particularly important because they help process and remove many drugs from the body. Other health conditions and the use of multiple medications can add another layer of complexity.

This is why medication reviews become increasingly important as people age.

The American Heart Association notes that polypharmacy, commonly defined as taking five or more chronic medications, is especially common among people with cardiovascular disease. A higher medication burden can increase the risk of adverse drug events and other problems, making periodic medication review important.

1. Blood Pressure Medications

Blood pressure medications are among the most important medicines for protecting cardiovascular health. Keeping blood pressure controlled can reduce the strain placed on the heart and blood vessels.

Common categories include ACE inhibitors, ARBs, beta-blockers, calcium-channel blockers, and diuretics.

However, these medications can sometimes cause side effects such as dizziness or excessively low blood pressure. For an older adult, dizziness can be particularly concerning because it may contribute to falls.

This does not mean blood pressure medication should be stopped. Instead, unusual dizziness, weakness, fainting, or significant changes in blood pressure should be discussed with a healthcare professional.

Medication doses sometimes need to be reassessed as health, kidney function, hydration, weight, and other medications change.

2. Diuretics and Fluid Balance

Diuretics, sometimes called “water pills,” help the body eliminate excess salt and water. They are commonly prescribed for conditions such as high blood pressure and certain forms of heart failure.

They can be highly beneficial, but fluid and electrolyte balance may require monitoring.

Older adults can be particularly vulnerable to dehydration or changes in electrolytes, especially during illness, hot weather, or periods of reduced fluid intake.

Anyone taking a diuretic should follow the prescribing clinician’s instructions and ask whether regular blood tests or other monitoring are necessary.

3. NSAID Pain Relievers

One of the most important medication categories for older adults to discuss with a healthcare professional is nonsteroidal anti-inflammatory drugs (NSAIDs).

Common examples include ibuprofen and naproxen.

These medicines are widely used for headaches, arthritis, muscle aches, and other forms of pain. However, NSAIDs can have cardiovascular and kidney-related concerns, particularly in people with existing heart or kidney problems.

The American Heart Association has advised minimizing NSAID use when possible in people with cardiovascular disease and using the lowest effective dose when these medications are necessary.

NSAIDs can also increase blood pressure in some people. The American Heart Association identifies ibuprofen and naproxen among over-the-counter medicines that can raise blood pressure.

For older adults with heart disease, high blood pressure, kidney disease, or multiple medications, it is particularly important to ask a doctor or pharmacist before using NSAIDs regularly.

4. NSAIDs and Aspirin: An Important Interaction

Aspirin deserves special attention because some people take low-dose aspirin for cardiovascular protection.

The FDA warns that ibuprofen can interfere with the heart-protective effect of aspirin when the two are taken together, depending on timing and circumstances. Anyone taking aspirin for cardiovascular protection should ask their healthcare professional about the safest way to use ibuprofen or other pain medicines.

It is also important not to assume that aspirin is appropriate for everyone simply because it is commonly used.

Whether an older adult should take aspirin for cardiovascular prevention depends on individual circumstances and should be discussed with a healthcare professional.

5. Decongestants for Colds and Allergies

Some over-the-counter cold and allergy products can be easy to overlook because they are not traditional “heart medications.”

Certain nasal decongestants, however, can raise blood pressure and may be problematic for people with heart disease or hypertension.

The FDA specifically advises people with heart disease or high blood pressure to ask a healthcare professional before using certain nasal decongestants.

This is a good reminder to check the active ingredients in combination cold and flu products. A single product may contain several medications, some of which could interact with prescription drugs.

6. Blood Thinners

Blood-thinning medications are frequently prescribed to people with certain cardiovascular conditions, including some individuals with atrial fibrillation or a history of blood clots.

These medications can significantly reduce the risk of dangerous blood clots, but they can also increase bleeding risk.

Older adults taking anticoagulants or antiplatelet medicines should tell their doctor or pharmacist about all prescription medications, over-the-counter pain relievers, vitamins, and supplements they use.

For example, the FDA warns that aspirin should not be added to prescription blood thinners such as warfarin unless a healthcare professional recommends it.

Unexplained bleeding, black or bloody stools, vomiting blood, or other concerning bleeding symptoms require prompt medical attention.

7. Certain Sleep and Allergy Medicines

Older adults sometimes use over-the-counter sleep aids or antihistamines without considering them “serious” medications.

That assumption can be misleading.

Some medications used for sleep, allergies, or nighttime cold symptoms can cause drowsiness and slow reactions. In older adults, this can increase the risk of falls and other complications.

The FDA notes that medication side effects can sometimes resemble other health problems, including dizziness, sleepiness, or memory difficulties.

If a new symptom appears after starting a medication—or after changing its dose—it is worth discussing the timing with a healthcare professional.

8. Supplements and Herbal Products

“Natural” does not automatically mean risk-free.

Herbal products and dietary supplements can interact with prescription medicines. They may affect how another medication works, alter its concentration in the body, or increase the risk of side effects.

The FDA specifically recommends including herbal preparations and supplements when discussing medications with healthcare professionals.

For an older adult taking several heart medications, adding a supplement without checking first can create an avoidable interaction.

9. Alcohol Can Change Medication Effects

Alcohol can interact with medications and may intensify certain effects, including sleepiness and impaired coordination.

The FDA notes that older adults may respond differently to alcohol and medication combinations as they age.

If you take several medications, particularly medicines that cause drowsiness or affect blood pressure, ask your healthcare professional whether alcohol is appropriate and whether there are specific restrictions.

10. Medication Combinations Matter

Sometimes the concern isn’t a single medication—it’s the combination.

An older adult may take:

• A blood pressure medication
• A cholesterol-lowering medication
• A blood thinner
• A diabetes medication
• A pain reliever
• A sleep aid
• Several vitamins or supplements

Each product may have a legitimate purpose, yet the overall combination can become complicated.

The FDA describes drug-drug, drug-food, drug-alcohol, and drug-condition interactions. An interaction can make a medicine less effective, increase its effects, or produce unexpected side effects.

That’s why medication reconciliation and regular reviews can be so valuable.

Symptoms That Shouldn’t Be Ignored

If an older adult starts experiencing a new symptom after beginning or changing a medication, don’t automatically assume it is simply part of aging.

Depending on the medication, symptoms that deserve medical discussion may include:

• Persistent dizziness
• Fainting
• Unusual weakness
• New swelling
• Unexplained shortness of breath
• Unusual or rapid heartbeat
• Significant changes in blood pressure
• Unusual bleeding
• Severe fatigue
• New confusion or excessive sleepiness

Some symptoms can have many causes, so they shouldn’t automatically be blamed on medication. The important point is to report new or worsening symptoms promptly.

Chest pain, severe difficulty breathing, fainting, or other symptoms that could indicate a medical emergency require immediate emergency medical care.

Never Stop a Heart Medication on Your Own

One of the most important rules is also one of the simplest:

Don’t stop a prescribed cardiovascular medication without talking to the healthcare professional who prescribed it.

Some medications need to be tapered rather than stopped suddenly. Others protect against serious complications even when you feel completely well.

The FDA specifically advises older adults not to skip doses or stop prescribed medication without first consulting a healthcare professional.

If a medication causes troublesome side effects, the answer may be a dose adjustment, a different medication, a different schedule, or additional monitoring—not necessarily stopping treatment altogether.

How to Make Medication Use Safer

A few simple habits can make medication management much easier.

Keep an Updated Medication List

Write down every medication you take, including:

• Prescription drugs
• Over-the-counter medicines
• Vitamins
• Herbal products
• Dietary supplements

Include the dose and when you take each product.

The FDA recommends keeping this list current and sharing it with healthcare providers.

Review Your Medicines Regularly

Ask your doctor or pharmacist to review your medications periodically, particularly if you’ve recently been hospitalized, diagnosed with a new condition, or started another prescription.

The goal is to determine whether every medication is still necessary, effective, and appropriate.

Read OTC Labels Carefully

Don’t assume an over-the-counter product is harmless simply because you can purchase it without a prescription.

Read the active ingredients and warnings every time you buy a new product.

Combination cold medicines are particularly important because one product may contain several active ingredients.

Ask Before Adding a Supplement

Before starting an herbal product, vitamin, or supplement, ask your doctor or pharmacist whether it can interact with your current medicines.

Monitor Your Health

Depending on your medications, your healthcare professional may recommend monitoring blood pressure, heart rate, kidney function, electrolytes, or other measures.

Keep track of relevant readings and report significant or persistent changes.

What a Medication Review Can Accomplish

A medication review isn’t simply about finding drugs to eliminate.

Sometimes the review confirms that a treatment is working well and should continue. In other situations, it may identify a duplicate medication, an unnecessary supplement, a troublesome interaction, or a dose that needs reassessment.

The American Heart Association describes deprescribing as a proactive, patient-centered process that can reduce medication burden when appropriate. Safe deprescribing involves systematic review, shared decision-making, careful tapering when necessary, and follow-up.

The key word is safe.

Medication changes should be individualized rather than based on a general list of drugs that someone “should never take.”

Frequently Asked Questions

Can common over-the-counter medicines affect the heart?

Yes. Some OTC medicines can affect blood pressure, fluid balance, bleeding risk, or interactions with prescription medicines. NSAIDs and certain decongestants are examples that may warrant particular caution in people with cardiovascular conditions.

Are prescription heart medications dangerous for older adults?

Not necessarily. Many cardiovascular medications provide substantial benefits. However, aging and changes in kidney function, liver function, other illnesses, and medication combinations can alter how drugs affect the body. Regular professional review can help balance benefits and risks.

Should older adults stop taking NSAIDs?

Not automatically. The appropriate choice depends on the person’s medical history, other medications, pain condition, and cardiovascular and kidney risks. Talk with a doctor or pharmacist before using NSAIDs regularly.

Should I stop taking my blood pressure medicine if I feel dizzy?

Don’t stop it on your own. Contact your healthcare professional and explain the symptoms. Your medication, dose, hydration status, blood pressure, or another medical issue may need to be evaluated.

Are herbal supplements safe with heart medications?

Not always. Supplements can interact with prescription drugs, so tell your doctor or pharmacist about everything you take.

The Bottom Line

Medications can be among the most effective tools for protecting an older adult’s heart—but they need to be used thoughtfully.

As people age, changes in the body and the increasing number of medications often taken for multiple health conditions can make interactions and side effects more likely. Common products such as NSAID pain relievers and certain decongestants deserve particular attention, while prescription cardiovascular medications should be monitored rather than stopped without professional guidance.

The safest approach is simple: keep an accurate medication list, read OTC labels, tell your healthcare team about supplements and nonprescription drugs, and schedule regular medication reviews.

And remember, medication advice should always be individualized. This article is for general education and is not a substitute for advice from a doctor, pharmacist, or other qualified healthcare professional.