Many might assume that over-the-counter (OTC) medications are generally safer than stronger prescription drugs, but research shows they can still present risks for some.

Certain common OTC painkillers have been linked to an increased risk of high blood pressure, stroke and heart attacks.

Potential risk of NSAIDs

Non-steroidal anti-inflammatory drugs (NSAIDs) — which are used to reduce pain, fever and inflammation — have been pinpointed as the class of medicines most linked to elevated cardiovascular risk.

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“This is because they reduce the production of certain chemicals called prostaglandins,” Maryam Jowza, M.D., an anesthesiologist at UNC Health in North Carolina, told Fox News Digital. “These chemicals are involved in inflammation, but they are also involved in other body functions, such as influencing the tone of blood vessels.”

Dr. Marc Siegel, Fox News senior medical analyst, echoed the potential risk of NSAIDs. 

“They can lead to high blood pressure, heart attack and stroke via fluid retention and salt retention,” he told Fox News Digital. “This increases volume, puts a strain on the heart and raises blood pressure.”

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Common examples of NSAIDs include ibuprofen, naproxen, aspirin, diclofenac, indomethacin and celecoxib.

Randomized trials found that ibuprofen caused the biggest spikes in blood pressure, followed by naproxen and then celecoxib. 

“In general, the increase in blood pressure is more likely with higher doses and longer duration of treatment,” said Jowza, who is also an associate professor in the Department of Anesthesiology at the UNC School of Medicine.

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NSAIDs can also increase stroke risk, especially at high doses and with long-term use, the doctor added. 

Diclofenac was linked to the highest cardiovascular risk, the doctor cautioned. Ibuprofen can also raise blood pressure and has been associated with a higher heart attack and stroke risk, but not as high as diclofenac. Naproxen carries a lower cardiovascular risk than ibuprofen or diclofenac, but is not entirely risk-free.

“The practical takeaway is that diclofenac is generally the least favorable choice in patients with elevated cardiovascular risk, and all NSAIDs should be used at the lowest effective dose for the shortest duration,” Dr. Nayan Patel, pharmacist and founder of Auro Wellness in Southern California, told Fox News Digital.

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Aspirin is an exception — although it is an NSAID, it actually reduces the risk of clots when taken at a low dose for prevention, under a doctor’s guidance. However, it can increase bleeding risk and blood pressure at high doses.

Non-NSAIDs safer, but not risk-free

Non-NSAID pain relievers are commonly used for everyday aches, headaches and fever, but not swelling. They act mainly on the brain’s pain signals, not inflammation, according to medical experts.

Acetaminophen, the most common non-NSAID pain reliever, is also linked to an increase in blood pressure, although to a lesser extent, according to Jowza. 

“All NSAIDs should be used at the lowest effective dose for the shortest duration.”

“Acetaminophen was once thought to have little to no cardiovascular effects, but more recent evidence suggests it can increase blood pressure, especially with higher doses used in the long term,” she said, emphasizing the importance of blood pressure monitoring. “Its effect on stroke risk is less clear.”

Which groups are most vulnerable?

The groups at greatest risk, according to doctors, are those with existing health conditions, such as high blood pressure, prior stroke or heart disease, diabetes or kidney problems.

“These groups are also more likely to experience NSAID-related fluid retention and destabilization of blood pressure control,” Patel said.

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Cardiovascular risk is generally higher for people 75 and older, the doctors agreed.

“Age amplifies risk largely because baseline cardiovascular risk increases with age, and kidney function reserve tends to decline,” Patel said. “Older adults are also more likely to be on antihypertensives, diuretics, antiplatelets or anticoagulants, so NSAIDs can destabilize blood pressure control and add safety complexity.”

Warning signs

Anyone experiencing chest pain, shortness of breath, sudden weakness or numbness, severe headache, confusion, slurred speech or vision changes should see a doctor immediately, Jowza advised.

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“These symptoms can point to a heart attack or stroke,” she warned. “Other symptoms of concern that may not develop as rapidly, like new swelling in the legs, should also prompt medical attention.”

“Patients should also seek medical advice if they notice signs of fluid retention or kidney stress, such as rapidly rising blood pressure, swelling in the legs, sudden weight gain over a few days, reduced urine output or worsening shortness of breath,” Patel added.

Safer alternatives

For those at higher risk, Patel recommends non-NSAID approaches whenever possible. 

“For many patients, this means starting with non-drug strategies such as heat or ice, physical therapy and activity modification,” he told Fox News Digital. “If medication is needed, acetaminophen is generally preferred over oral NSAIDs from a cardiovascular standpoint, although regular use should still be monitored in people with hypertension.”

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For localized joint or muscle pain, the doctor said topical NSAIDs can offer “meaningful relief” with “far lower” risk.

“Overall, pain management in high-risk patients should emphasize targeted therapy, conservative dosing and close blood pressure monitoring.”

Bottom line

The doctors emphasized that the overall risk is “very low” for people taking OTC pain relievers on a short-term basis, but it rises with long-term, high-dose use.

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“I would not hesitate to use an occasional dose if it were a low-risk individual with no prior history of heart attack or stroke,” Jowza said. “I also think short-term use in diabetics and hypertensives who are well-controlled is acceptable.”

For those taking NSAIDs, the doctor suggested using “guard rails” — such as regularly testing blood pressure and kidney function, and setting limits on dosing — to make treatment as safe as possible.

Patel agreed that for most healthy individuals, occasional NSAID use “does not carry a meaningful cardiovascular risk.”

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“The concern is primarily with repeated or chronic use, higher doses, and use in people with underlying cardiovascular, kidney or blood pressure conditions,” he confirmed to Fox News Digital.

“That said, large population studies show that cardiovascular events can occur early after starting NSAIDs, particularly at higher doses, which is why even short-term use should be approached cautiously in higher-risk patients.”  

The New York State Department of Health has announced the highest number of flu hospitalizations recorded in a single week.

The state confirmed the uptick in hospital visits in a press release on Jan. 2, as flu cases continue to rise in the region and nationwide.

New York State, including New York City, has consistently tracked the highest numbers of recorded respiratory illness cases in the country for the last few weeks, according to CDC data. Several other states have climbed to the “very high” category for respiratory activity as well, as of the week ending Dec. 27.

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The most recent data from the New York health department showed a total of 4,546 hospitalizations from Dec. 26, 2025, to Jan. 2, 2026 – a week-over-week increase of nearly 1,000. The prior week, the department announced the highest number of flu cases ever recorded in a single seven-day period.

In a statement, New York’s Acting Commissioner of Health Dr. James McDonald noted the severity of this flu season compared to previous years.

“Almost 1,000 more people were admitted to a hospital during this most recent seven-day period compared to the prior week,” he confirmed. “There is still time to get a flu shot, and remember, flu can be treated with antiviral medication if started within 48 hours of symptom onset [as] your doctor deems appropriate.”

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Health officials are pushing for Americans to consider getting the flu vaccine, as experts consider it to be a top line of defense for preventing viral exposure and spread.

In a previous interview with Fox News Digital, Dr. Neil Maniar, professor of public health practice at Boston’s Northeastern University, emphasized that it’s not too late to get the flu vaccine, as peak season typically occurs in January.

“The vaccine still provides protection against serious illness resulting from the subclade K variant that seems to be going around,” he said.

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Even healthy individuals can become seriously ill from the flu, Maniar noted, “so a vaccine is beneficial for almost everyone.”

“Individuals typically start to develop some degree of protection within a few days and gain the full benefit within about two weeks, so now is the time for anyone who hasn’t gotten the vaccine yet.”

Flu symptoms can include fever, chills, headache, fatigue, cough, sore throat and runny nose.

A mutation of influenza A H3N2, called subclade K, has been detected as the culprit in rising global cases, causing more intense symptoms and higher risk of spread.

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“It’s becoming evident that this is a pretty severe variant of the flu,” Maniar said. “Certainly, in other parts of the world where this variant has been prevalent, it’s caused some severe illness, and we’re seeing an aggressive flu season already.”

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New York State recommends taking preventive actions to avoid flu infection. These include washing hands often; avoiding touching the eyes, nose and mouth; avoiding close contact with sick people; cleaning and disinfecting objects and surfaces; and staying home when feeling sick.

When someone gets a cancer diagnosis, the initial reaction is usually to undergo treatment as quickly as possible — but for some types of disease, doctors may recommend a more conservative approach.

For certain cancers, immediate or aggressive treatment can cause more harm than good, according to multiple medical experts.

For example, treating slow-growing tumors with surgery, radiation or chemotherapy could create significant side effects without a survival benefit.

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“The fact that so many cancers will never kill you is not a justification for not knowing, because there is still plenty of room for ‘watchful waiting,’ as well as interventions that may improve quality of life even if they don’t extend life,” Dr. Marc Siegel, Fox News senior medical analyst, told Fox News Digital.

This is especially true as targeted cancer treatments emerge, which are more personalized and less likely to cause severe side effects, according to the doctor.

“The fact that cancers are occurring earlier is a justification for heightened screenings, not the opposite,” Siegel added. “Information is power — what you do with that information is based on clinical judgment and the art of medicine.”

Below are some types of cancer that may not warrant treatment, according to research and doctors’ guidance.

No. 1: Prostate cancer (low-risk)

While some types of prostate cancer should be treated right away, others are better addressed by “watchful waiting,” according to Sanoj Punnen, M.D., a urologic oncologist with Sylvester Comprehensive Cancer Center, part of the University of Miami Health System. 

“With respect to prostate cancer, for most low-risk cancers (Gleason 6 or grade group 1), we recommend initial observation and surveillance rather than immediate treatment,” he told Fox News Digital.

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The Gleason score is a grading system that ranks prostate cancer cells in terms of how abnormal they are, with 6 being the lowest grade and 10 being the highest grade (barely resembling normal cells).

“For high-grade tumors like Gleason 8, 9 or 10, we believe they progress quickly, so we recommend treatment to prevent the risk of metastasis,” said Punnen, who is also vice chair of research and a professor with the Desai Sethi Urology Institute at UHealth. “For low-risk tumors, we think they pose little risk, so we recommend just observation.”

“The fact that cancers are occurring earlier is a justification for heightened screenings, not the opposite.”

“But in the end, we can’t be sure, so our approach to observation includes serial monitoring of cancer status with PSA, MRI and occasional biopsy to ensure the tumor isn’t progressing.”

No. 2: Ductal carcinoma in situ (DCIS) 

Also known as stage 0 breast cancer, DCIS is a non-invasive disease marked by abnormal cells in the lining of the breast milk ducts. The “in situ” is Latin for “in the original place,” which indicates that the cancer has not spread outside the milk ducts.

For this precancerous, very early-stage breast condition, careful monitoring may be more prudent than immediate surgery, research shows.

A 2024 study by the Dana-Farber Cancer Institute found that active monitoring for DCIS resulted in similar quality of life, mental health and symptom progression over a two-year period compared to a standard surgical approach.

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“These results suggest that in the short term, active monitoring is a reasonable approach to management of low-risk DCIS,” the lead researcher said in a press release. “If longer-term follow-up supports the safety of active management from a cancer outcome standpoint, this approach could be considered as an option for women with this condition.”

“But it is also critical that we understand how women feel when they are living with this ‘watch and wait’ approach and how it impacts their overall quality of life.”

Other research has suggested that women with low-risk DCIS did not have a higher rate of invasive cancer after two years of active monitoring, although each patient should discuss their individual risk level with an oncologist.

No. 3: Indolent (slow-growing) lymphomas

Non-Hodgkin lymphoma (NHL) is a type of cancer that starts in the lymphatic system, which includes the lymph nodes, spleen, thymus, bone marrow and other tissues. 

Indolent lymphomas are those that “grow and spread slowly,” according to the American Cancer Society.

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The National Comprehensive Cancer Network (NCCN) recommends watchful waiting for asymptomatic, slow-growing follicular lymphoma, as a means of avoiding the toxicity of chemotherapy and immunotherapy until it’s absolutely necessary.

The Lymphoma Research Foundation confirms that doctors recommend “active surveillance” for some patients with slow-growing lymphoma.

“This approach may be started after the initial diagnosis or after relapse, depending on the situation,” the foundation states on its website. “Active treatment is started if the patient begins to develop lymphoma-related symptoms or if there are signs that the disease is progressing.”

Treatment should be started right away for aggressive (fast-growing) lymphomas.

No. 4: Chronic lymphocytic leukemia

One of the most common adult leukemias, chronic lymphocytic leukemia (CLL) originates in white blood cells (lymphocytes) in the bone marrow and then spreads to the bloodstream, according to the American Cancer Society.

CLL tends to grow slowly, with many patients experiencing no symptoms for years. Eventually, the cancer calls can spread to the lymph nodes, liver and spleen.

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Some studies have shown that early treatment for CLL does not improve survival rates compared to observation, and that the benefits may not outweigh the risks.

In a 2023 study presented at the European Hematology Association 2023 Congress in Frankfurt, Germany, researchers found that early treatment did not prolong overall survival compared to a placebo in patients with early, asymptomatic CLL.

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“I believe it’s fair to conclude that ‘watch-and-wait’ should remain the standard of care in the era of targeted drugs,” said researcher Petra Langerbeins, M.D., when presenting the findings.

No. 5: Low-grade endometrial cancer

For most patients with endometrial cancer, surgery is the first treatment, which entails removing the uterus, fallopian tubes and ovaries, according to the American Cancer Society.

However, in certain patients with low-grade cancer, such as older people, those with “frailty” and people with major health issues, doctors may recommend deferring surgery, which can pose a high risk.

In cases where the patient has medical comorbidities or wants to preserve fertility, hormone treatment may be used instead of surgery, per the ACS.

“It’s usually also considered for cancer that is lower-grade, low-volume and slow-growing,” the above source stated.

No. 6: Some early kidney cancers

In cases of kidney cancer with small tumors (≤3 cm) or benign lesions, doctors may recommend monitoring them instead of undergoing surgery for removal.

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The American Urological Association confirms that active surveillance is an option for some small renal masses (localized tumors).

“I believe it’s fair to conclude that ‘watch-and-wait’ should remain the standard of care in the era of targeted drugs.”

Deferred treatment is particularly recommended for older patients or those with “significant comorbidities,” research shows.

“Shared decision-making about active surveillance should consider risks of intervention/competing mortality versus potential oncologic benefits of intervention,” the UAU states in its guidance.

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Data from the Delayed Intervention and Surveillance for Small Renal Masses (DISSRM) Registry showed that patients with active surveillance had a 99% or greater cancer-specific survival rate — virtually the same as patients who received immediate treatment.

No. 7: Small papillary thyroid cancers

Papillary thyroid cancer (PTC), the most common type of thyroid cancer, may not warrant treatment for small tumors measuring 1 centimeter (10 mm) or less, which are called microcarcinomas.

Research found that when using active surveillance for 10 to 20 years, less than 10% experienced significant growth, only 5% developed lymph node spread and there were no thyroid-cancer deaths.

The American Thyroid Association’s guidelines officially recommend active surveillance for very low-risk microcarcinomas.

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While many patients with low-risk tumors can safely delay treatment, this does not apply to all cancers or all patients. 

As cancer behavior and personal health factors vary widely, patients should consult their doctor to determine the most appropriate course of care based on their individual risk level.