But regular or high-dose use has been associated with fluid retention and elevated blood pressure—both of which put extra work on the heart. The FDA includes warnings about increased risk of heart attack and stroke, particularly in older adults or those with existing risk factors.
Studies, including large reviews published in journals like The BMJ, have found the risk rises with duration and dose. Many people notice no immediate symptoms, which makes the long-term concern easy to overlook.
Safer alternatives often include acetaminophen, topical NSAIDs, or physical therapy approaches—worth discussing with your provider.
4. Proton Pump Inhibitors (PPIs)
Drugs like omeprazole (Prilosec) and esomeprazole (Nexium) effectively control chronic acid reflux and ulcers.
Long-term use (beyond a few months) has been linked in observational studies to low magnesium levels, which can affect heart rhythm. Some research, including analyses in journals like Circulation, has suggested a possible modest increase in cardiovascular events, though findings aren’t universal.
The mechanism may involve reduced nutrient absorption or effects on blood vessels. Doctors often recommend using the lowest effective dose for the shortest time needed, with periodic reviews.
Lifestyle changes—smaller meals, elevating the head of the bed, avoiding trigger foods—can reduce reliance on these medications.
3. Oral Decongestants
Pseudoephedrine (found in Sudafed and many combination cold remedies) quickly clears nasal congestion.
It works by narrowing blood vessels, which can also raise blood pressure systemically—a particular concern for older adults with hypertension or heart disease. Medical organizations caution against routine use in people with cardiovascular conditions.
