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Why cardiologists urge caution with ibuprofen

Ibuprofen is one of the most commonly used over-the-counter pain relievers, found in brands like Advil and Motrin. While it’s effective for reducing fever, headaches, and muscle aches, many cardiologists advise caution—especially for people with underlying health conditions.

The concern lies in how ibuproen affects the cardiovascular system. It belongs to a class of drugs called nonsteroidal anti-inflammatory drugs (NSAIDs), which can interfere with normal kidney function and fluid balance. This, in turn, may lead to a rise in blood pressure. For someone already managing hypertension, even short-term use of ibuprofen can make it harder to keep pressure under control.

Beyond raising blood pressure, regular use of ibuprofen has been linked to an increased risk of heart attack and stroke, particularly in people with existing heart disease. It can also worsen heart failure by promoting fluid retention, which puts added strain on the heart. The kidneys, too, are vulnerable—prolonged NSAID use can lead to kidney damage, especially in older adults or those with reduced kidney function.

That doesn’t mean ibuprofen is dangerous for everyone. For most healthy people, occasional use at the lowest effective dose is generally safe. But if you have high blood pressure, heart disease, or kidney issues, it’s wise to talk to your doctor before reaching for it. Often, safer alternatives like acetaminophen (Tylenol) may be recommended.

The bottom line? Just because a drug is available without a prescription doesn’t mean it’s risk-free. As cardiologists often emphasize: small choices, like which pain reliever you take, can have a big impact on heart health over time.

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How is a PDA closed?

When a baby is born, a small blood vessel called the patent ductus arteriosus (PDA) often remains open. In many cases, especially with premature infants or those with heart conditions, this vessel doesn’t close on its own as it should shortly after birth. While small PDAs may close spontaneously within the first few months of life, some require medical intervention.

For children who need treatment, doctors typically use a minimally invasive procedure rather than open surgery. This involves a technique known as cardiac catheterization. A thin, flexible tube called a catheter is inserted into a blood vessel—usually in the leg—and carefully guided up to the heart and into the PDA.

Once in place, a small device is passed through the catheter and positioned within the PDA, acting like a plug to seal it off. Over time, the body’s natural healing process takes over, and the tissue grows around the device, permanently closing the vessel. This approach avoids the risks and longer recovery time associated with surgery and is now the preferred method for most patients.

The entire procedure is done under imaging guidance, often with X-rays or echocardiography, ensuring precision and safety. Most children go home within a day or two and resume normal activities quickly.

While every case is different, advances in cardiac care mean that closing a PDA is now safer, less invasive, and highly effective. If your child has been diagnosed with a PDA, your pediatric cardiologist will help determine the best course of action based on the size of the vessel, symptoms, and overall health.

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Preferred medications for treating Patent Ductus Arteriosus in newborns

Patent Ductus Arteriosus (PDA) is a common condition in premature infants, where the ductus arteriosus— a blood vessel that connects two major arteries in the fetal heart—fails to close after birth. If left untreated, it can lead to complications such as heart failure or respiratory distress. The good news is that effective medical treatments are available, especially when administered early.

IV indomethacin has long been the drug of choice for closing a PDA in neonates, particularly when given within the first 10 to 14 days of life. This window is critical because the ductus tends to become less responsive to medication as time passes. Indomethacin works by inhibiting prostaglandin synthesis, which plays a key role in keeping the ductus open during fetal development. By blocking this pathway, the medication promotes closure of the vessel.

In recent years, IV ibuprofen has emerged as a viable alternative, offering similar efficacy with potentially fewer side effects, especially concerning kidney function and platelet inhibition. Some neonatal intensive care units now prefer ibuprofen due to its more favorable safety profile, although both drugs are widely used depending on institutional protocols and patient factors.

While surgical ligation remains an option for cases unresponsive to medication, pharmacological closure remains the first-line approach in eligible preterm infants. Timing is essential: early diagnosis and treatment within the first two weeks significantly improve success rates. The choice between indomethacin and ibuprofen depends on the baby’s clinical condition, gestational age, and individual risk factors.

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