Can Ibuprofen Cause Heart Attacks? Risks, Evidence & Safety Guidelines

Understanding the connection between ibuprofen, NSAIDs, and your heart—what the latest science says about heart attack risks.

By Medha deb

Created on Sep 25, 2025

Understanding the connection between ibuprofen, NSAIDs, and your heart—what the latest science says about heart attack risks.

Ibuprofen is a widely used nonsteroidal anti-inflammatory drug (NSAID) known for its effectiveness in relieving pain, fever, and inflammation. However, questions about its safety—especially in relation to heart health—have emerged over the past decades. This article explores current scientific understanding of how ibuprofen and other NSAIDs may impact your heart, details who is most at risk, and offers guidance for safe use and alternative pain management options.

What is Ibuprofen?

Ibuprofen, often sold under brand names such as Advil and Motrin, is one of the most common over-the-counter (OTC) pain relievers worldwide. It belongs to the class of NSAIDs, a group of drugs widely used to treat various forms of pain, inflammation, and fever.

Common uses include temporary relief of mild to moderate pain from headaches, muscle aches, arthritis, menstrual cramps, toothaches, and backaches.
Ibuprofen works by blocking the body’s production of certain natural substances (prostaglandins) that cause inflammation and pain.
Other popular NSAIDs include naproxen (Aleve), diclofenac (Voltaren), and celecoxib (Celebrex).

Does Ibuprofen Increase the Risk of Heart Attack?

Multiple scientific reviews and regulatory agencies, including the U.S. Food and Drug Administration (FDA), have determined that ibuprofen can increase the risk of heart attack or stroke—especially when used in higher doses and over longer periods.

NSAID	Heart Attack Risk↑	Stroke Risk↑	Notes
Ibuprofen	Yes	Yes	Risk increases with dose & duration
Naproxen	No/Low*	Yes	Mixed evidence but generally considered lower risk for heart attack
Diclofenac	Yes	Yes	Higher risk at prescription strength
Celecoxib	Yes	Yes	COX-2 inhibitor; increased risk linked to its class
Aspirin	No**	No**	Exception; even protective for heart at low doses

*Naproxen is sometimes considered the ‘safest’ among NSAIDs for heart attack risk, but it still raises stroke and heart failure risk.
**Aspirin is not included in the heart risk warning for NSAIDs and is sometimes prescribed for heart attack and stroke prevention.

How Does Ibuprofen Affect the Heart?

The ways NSAIDs like ibuprofen may harm the heart include:

Raises blood pressure: NSAIDs can cause your body to retain salt and fluid, leading to increased blood pressure. In people with high blood pressure (hypertension), this effect can be significant.
Can worsen heart failure: Fluid retention and increased blood pressure can overload the heart, especially in those with preexisting heart disease or heart failure.
Increases clot risk: By blocking certain enzymes (cyclooxygenases, especially COX-2), NSAIDs reduce levels of prostacyclin, a substance that normally helps prevent clotting and keeps blood vessels widened. This imbalance can encourage clot formation, the direct cause of most heart attacks and strokes.
Effects occur quickly: Evidence shows that the risk of heart attack can increase within days or weeks of starting NSAIDs, not just after long-term use.

What Does the Science Say? Key Research on NSAIDs and Cardiovascular Risk

Multiple major reviews and studies over the past two decades support the link between NSAIDs and increased cardiovascular risk:

2005 & 2015 FDA Warnings: The U.S. FDA first warned of this risk in 2005 and strengthened its warning in 2015, noting that heart attack or stroke can occur even with short-term use. People with heart disease or its risk factors (such as high blood pressure, diabetes, or smoking) are at particular risk.
Major Reviews:

A 2011 review found ibuprofen, diclofenac, and celecoxib increased heart attack risk; naproxen did not, although all raised stroke risk.
A 2013 review of 750+ studies associated prescription-strength ibuprofen and diclofenac with increased cardiovascular events. Naproxen again appeared relatively safer for heart attack but not for stroke or heart failure.
A 2017 review found that all NSAIDs (including ibuprofen, naproxen, diclofenac, celecoxib) increased heart attack risk, greatest between 8–30 days of use, with higher doses posing higher risk.

Overall, while individual studies may disagree on which NSAIDs carry the most risk, there is consistent evidence that all non-aspirin NSAIDs can raise your risk of a cardiovascular event, especially with higher doses, prolonged use, or preexisting heart risks.

Who Is Most at Risk?

You may be at higher risk for adverse heart events from ibuprofen and other NSAIDs if you:

Have a history of heart disease (angina, heart attack, previous bypass or stenting)
Have risk factors for heart disease (high blood pressure, high cholesterol, diabetes, obesity, family history of heart conditions, or are over age 65)
Take NSAIDs in high doses or for long periods
Already have kidney disease or heart failure

For most healthy adults who use ibuprofen occasionally and as directed (low doses for brief periods), the absolute risk increase is small. However, people with existing cardiovascular risk factors need to be especially cautious.

Ibuprofen and Heart Health: Official Warnings

All non-aspirin NSAIDs, including ibuprofen, carry an FDA-mandated black box warning regarding their potential to cause fatal cardiovascular events.

“Cardiovascular Risk: May increase risk of serious and potentially fatal cardiovascular thrombotic events, myocardial infarction (MI), and stroke. Risk may increase with duration of use. Increased risk if existing cardiovascular disease or risk factors.”

Can Ibuprofen Increase Blood Pressure?

Yes—NSAIDs can cause both new and worsening high blood pressure (hypertension).

This is due to the drug’s effects on fluid and salt retention in the body and reduced blood flow to the kidneys.
People with pre-existing hypertension should be particularly vigilant, as uncontrolled high blood pressure itself increases heart risk.

Comparing NSAIDs: Is Ibuprofen Safer Than Others?

The evidence is mixed and sometimes contradictory regarding which NSAID is the “safest” for the heart:

Naproxen has consistently shown a lower risk of heart attack than ibuprofen or diclofenac in some studies—though all NSAIDs pose some cardiovascular risk.
Diclofenac and COX-2 inhibitors (such as celecoxib) have been linked to higher risks, especially at prescription-strength doses.
All non-aspirin NSAIDs increase the risk of hospitalization for heart failure and can raise blood pressure or stroke risk.

Ultimately, the choice of NSAID should consider your overall health profile, existing medical conditions, other medications, and specific pain management needs. Consultation with a healthcare professional is advised.

Tips for Safe NSAID Use

Use the lowest effective dose for the shortest possible duration.
Check with your healthcare provider before using NSAIDs if you have heart disease, high blood pressure, kidney problems, or take other medications.
Monitor your blood pressure while using ibuprofen or other NSAIDs, especially if you have a history of hypertension.
Avoid combining multiple NSAIDs at the same time unless specifically directed by your doctor.
If you need daily pain relief for a chronic condition, discuss other pain management strategies with your doctor.

People Who Should Avoid or Limit NSAIDs

History of heart attack, angina, bypass surgery, or stent placement
Stroke or TIA (mini-stroke) history
Heart failure or chronic kidney disease
Severe, uncontrolled hypertension
Those taking blood thinners or certain blood pressure medications

Alternatives to Ibuprofen for Pain Relief

If you’re concerned about heart risks, consider these alternatives after consultation with a healthcare provider:

Acetaminophen (Tylenol): Generally not linked to increased heart attack or stroke risk, but can affect the liver.
Physical therapy and exercise: Proven to reduce pain and improve function for many chronic pain conditions.
Topical NSAIDs: Creams or gels with NSAIDs (like diclofenac gel) may offer pain relief for joints with less risk of systemic side effects.
Lifestyle approaches: Maintaining a healthy weight, quitting smoking, and following a heart-healthy diet can help reduce both pain and heart risk.
Prescription options: For chronic or severe pain, other classes of medications or targeted interventions may be appropriate.

Always consult a healthcare professional before starting or changing any medication or supplement regimen, especially if you have underlying health conditions.

How to Talk to Your Doctor About NSAIDs and Heart Risks

Tell your physician about all medications, supplements, and over-the-counter products you use.
Discuss your personal and family health history, including any heart, blood pressure, or kidney problems.
If you rely on NSAIDs frequently, ask about monitoring your blood pressure and kidney function.
Explore alternative pain management plans, especially if you have increased heart risk.

Frequently Asked Questions (FAQs)

Q: Is it dangerous to take ibuprofen if I have high blood pressure?

A: Ibuprofen can raise blood pressure and may worsen existing hypertension, increasing the risk of heart attack or stroke. Talk with your doctor before use if you have high blood pressure.

Q: How soon does the risk of heart attack increase after starting NSAIDs?

A: The risk of heart attack or stroke can begin within a few weeks of NSAID use. The risk rises with higher doses and longer usage periods.

Q: Are any pain relievers safer for heart health than NSAIDs?

A: Acetaminophen (Tylenol) is generally considered safer for people with heart disease, though it should be used cautiously in those with liver disease.

Q: Does low-dose aspirin carry the same risk as ibuprofen or other NSAIDs?

A: No. Low-dose aspirin is often used to help prevent heart attacks and strokes and is considered protective for many at-risk patients.

Q: Can short-term, low-dose use of ibuprofen cause a heart attack?

A: For most healthy adults, occasional use at recommended doses poses minimal heart risk. People with preexisting heart problems or risks should be cautious, even with short-term use.

Key Takeaways

All non-aspirin NSAIDs—including ibuprofen—can increase the risk of heart attack and stroke, especially with prolonged or high-dose use.
Be especially cautious if you have a history of heart disease, high blood pressure, kidney disease, or other cardiovascular risk factors.
Follow the lowest effective dose for the shortest period guideline and consult your healthcare provider for safe pain management options.

Always consult your physician for guidance on choosing the safest pain relief approach for your unique circumstances. This content is intended for informational purposes only and should not be used as a substitute for professional medical advice.

References

Author

medha deb

Medha Deb is an editor with a master's degree in Applied Linguistics from the University of Hyderabad. She believes that her qualification has helped her develop a deep understanding of language and its application in various contexts.

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