It’s crucial to be aware that several of the most popular over-the-counter (OTC) treatments for congestion, aches, pains, and low-grade fevers contain medications that could affect the cardiovascular system as the cold and flu season continues this year. Nonsteroidal anti-inflammatory medicines (NSAIDs) and decongestants are among the most common of these medications.

NSAIDs and your heart

A modest increase in the relative risk of suffering a heart attack, stroke, heart failure, atrial fibrillation, elevated blood pressure, and blood clots is linked to the use of certain NSAIDs. By preventing the COX enzyme, which generates prostaglandins, NSAIDs reduce pain and inflammation. However, this enzyme also has other significant effects on other bodily systems that could affect cardiovascular risk. For instance, the suppression of COX-2, a type of COX found in the blood vessel lining, may affect the healing, relaxation, and clotting of blood vessel injuries. Inhibiting COX-2 in the kidney may change fluid retention, which may impact blood pressure and the signs and symptoms of heart failure.

Large population studies have shown that individuals without a history of cardiovascular disease are more likely to experience two additional cardiovascular events (like a heart attack or stroke) per 1,000 people per year when using NSAIDs similar to those found in over-the-counter cold and flu remedies (CVD). This connection rises to an extra seven to eight cardiovascular incidents per 1,000 people each year among those with a history of CVD.

It’s important to note that the majority of the participants in these trials used NSAIDs for extended periods of time (more than a month) due to chronic pain or inflammatory diseases. The shortest duration, lowest dose, and most frequent use of these medications can reduce the cardiovascular risk associated with NSAIDs, as is frequently the case during brief episodes of the cold or the flu.

Therefore, among people without CVD, using NSAIDs like ibuprofen (Advil, Motrin), naproxen (Aleve), or naproxen sodium (Naprosyn), is typically a reasonable alternative for momentary symptom alleviation. It is important to discuss the usage of NSAIDs with a doctor if you have CVD.

When an alternative medicine, like acetaminophen (Tylenol), is not an option for people with CVD, it is frequently OK to use NSAIDs for a brief period of time. But in this situation, the NSAID you choose might matter. According to some studies, celecoxib (Celebrex), a COX-2 selective NSAID, and naproxen may have slightly less of a connection with cardiovascular disease (CVD) in high-risk patients.

Before taking NSAIDs, even for a few days, some people should obviously consult a doctor. These people include those with heart failure, those taking blood thinners like warfarin, rivaroxaban (Xarelto), apixaban (Eliquis), or dabigatran (Pradaxa), those taking antiplatelet drugs like aspirin (Bayer, Bufferin), clopidogrel (Plavix), prasugrel (Effient), or ticagrelor (Brilinta), and those who have recently experienced

The heart and decongestants

Decongestants that influence the cardiovascular system include phenylephrine (Sudafed PE Congestion, Suphedrin PE) and pseudoephedrine (Sudafed Congestion, Suphedrin). These substances narrow or constrict blood arteries by acting on the “fight or flight” reflex. Runny noses and congestion are dried up, however this can also raise blood pressure and alter heart rate. As opposed to NSAIDs, these medications’ long-term impact on events like heart attacks and stroke have not been as thoroughly investigated. Clinical research has shown that these medications can occasionally have negative effects in people who are particularly susceptible to rapid increases in blood pressure or heart rate.

When taken for brief periods of time, these decongestants are virtually always safe for use in people without CVD. It is always better to utilise the lowest dose and frequency for the shortest amount of time, much like with NSAIDs.

But it’s probably preferable to avoid these drugs in people with established CVD. This is especially true for people who have coronary artery disease, difficult-to-control blood pressure, or heart failure. In these circumstances, the body might not be able to handle blood vessel constriction and abrupt fluctuations in blood pressure and heart rate as well.

NSAIDs and decongestants, among other OTC medications for the common cold and flu, can harm the cardiovascular system. Even when used briefly, these effects can have serious repercussions for some patients with established CVD. If you fit this description, talk to your cardiologist about your risk factors and possible treatment choices.