Taking certain painkillers daily for some years carries a small increased risk of heart attack and stroke, research has recommended.
The findings transmit to non-steroidal anti-inflammatory drugs like ibuprofen prescribed long-term to treat painful conditions such as arthritis.
People taking them now and again are at minimum risk, say experts.
A Swiss team analyzed data from existing large-scale studies comparing use of non-steroidal anti-inflammatory drugs (NSAIDs) - naproxen, ibuprofen, diclofenac, celecoxib, etoricoxib, rofecoxib and lumiracoxib - with other drugs or placebo.
One of the drugs - rofecoxib was withdrawn in 2004 when other studies found a raised risk of heart attacks
Most of the patients were aged, with conditions like osteoarthritis, and were taking too much of doses of NSAIDs daily for at least a year.
The researchers found the medicine greater than before the risk of death from stroke or heart attack by between two and four times, compared with placebo.
Peter Joni, professor of clinical epidemiology at the University of Bern, Switzerland, told the BBC: For aged (people) with musculoskeletal pain there must be take severe care when prescribing or taking these drugs.
But he stressed that the findings did not relate to people taking anti-inflammatory currently and again for symptoms such as period pain or sports injuries.
Commenting on the research, the British Heart Foundation said any person worried about their medication should speak to their doctor.
Medical director Professor Peter Weisberg said: This confirms what has be known for some years now - taking non-steroidal, anti-inflammatory drugs on a usual basis increases heart attack or stroke risk.
However, some patients with incapacitating joint pains may consider the small increased risk valuable when set against the improvement in their quality of life that these drugs bring.
Anyone who needs regular painkillers should talk to their doctor about which drug is the most appropriate for them. There are lots than can be done to mitigate any potential risks.
These commentaries were echoed by Simon Maxwell, Professor of Clinical Pharmacology at the University of Edinburgh.
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