Which NSAID is considered safest for a patient with a history of hypertension concerned about heart risks?

Naproxen is often regarded as the safest nonsteroidal anti-inflammatory drug (NSAID) for patients with a history of hypertension when there are concerns about cardiovascular risks. This belief is supported by research that suggests naproxen has a lower risk of cardiovascular events compared to other NSAIDs, especially when used at lower doses.

The mechanism behind this involves the way naproxen affects platelet aggregation and its impact on blood pressure. Other NSAIDs, such as ibuprofen and diclofenac, can increase blood pressure and have been linked to a higher risk of heart attacks and strokes in certain populations. Indomethacin is associated with higher cardiovascular and gastrointestinal risks, making it less suitable for patients who are already at risk.

Naproxen, especially when taken in controlled doses and under medical supervision, is often chosen for patients with pre-existing hypertension due to its relatively safer profile regarding cardiovascular events. This choice relies on balancing the effective management of pain and inflammation with the need to minimize cardiovascular risk, particularly in vulnerable populations.