According to new research published in the July edition of the American Journal of Medicine, patients with heart disease and high blood pressure who take a certain class of non-steroidal anti-inflammatory drugs (NSAIDs) are at greater risk of heart attack, stroke and even death.

Popular painkillers such as aspirin, Celebrex, Advil, Motrin and Aleve are among the NSAIDs believed to be harmful when used chronically by patients with coronary artery disease. The study’s lead author, Dr. Anthony A. Bavry, said in a journal release that, “Among coronary artery disease patients with hypertension, chronic self-reported use of NSAIDs was associated with harmful outcomes, and this practice should be avoided where possible.”

The study specifically followed 882 long-term users of NSAIDs, as well as approximately 22,000 people who used them less frequently over the course of about three years. Dr. Bavry and his colleagues ultimately found that the patients with high blood pressure and coronary artery disease who took painkillers regularly had a 47 percent increase in the rate of death, non-fatal heart attack and stroke.

A panel of experts for the American Geriatrics Society recently recommended that elderly patients use acetaminophen as a first-line defense for the treatment of chronic pain, and further suggested that nonselective NSAIDs only be used with great caution.