NSAID are largely used for muscle, bone and joint pain, but are associated with important cardiovascular, renal and haematological adverse effects, mainly in elderly people. They may determine a blunted response to the antihypertensive drugs, water retention and worsening of the renal function in patients with high blood pressure, heart failure and chronic kidney disease from any cause, including diabetes. The most recent guidelines recommend to limit NSAID for the pain control in patients affected by such diseases, and to prefer paracetamol, tramadol and short-lived oppioids as an alternative, as far as possible.