An Aspirin a Day: Is It Right for You?
Some people may be able to take aspirin every day to lower heart attack or stroke risks. Learn if you're a candidate for daily aspirin therapy.
Aspirin has long been touted as a wonder drug. The ancient Greeks used the natural form of aspirin, which came from willow trees, as medicine.
Aspirin is a staple for treating headaches, aches and pains. Studies show it can also help prevent heart attacks and strokes.
If aspirin can help treat so many conditions, should you take it every day?
The need to take aspirin every day may depend on your risk for heart attack or stroke and your age. Any need also has to be balanced with the potential for aspirin to cause bleeding in the stomach or intestines.
The U.S. Preventive Services Task Force (USPSTF) provides these guidelines for doctors to use:
•Encourage men between ages 45 and 79 to use aspirin when the potential benefit of cutting heart attack risk outweighs the potential harm of increased bleeding in the stomach or intestines.
•Encourage women from 55 to 79 to use aspirin when the potential benefit of a reduction in ischemic strokes outweighs the potential harm of more bleeding in the stomach or intestines.
•Women younger than 55 years old and men younger than 45 should not be advised to take daily aspirin to prevent heart disease.
•For people age 80 years or older, there is not enough evidence to recommend taking aspirin to prevent heart disease.
The American Diabetes Association, American Heart Association and the American College of Cardiology offer more specific advice for people with diabetes. They recommend low-dose aspirin therapy for:
•People with diabetes at increased risk for heart disease who are not at increased risk for bleeding. This includes men over age 50 and women over age 60 with at least one other risk factor for heart disease.
They also suggest that doctors may consider low dose aspirin therapy for:
•People with diabetes who have an intermediate risk for heart disease and are not at increased risk for bleeding. This includes younger people with diabetes who have at least one other risk factor for heart disease. It also includes older people with diabetes who don't have any other risk factors for heart disease besides diabetes.
Note that some of these suggestions differ from the USPSTF's guidelines. If you have diabetes, talk to your doctor to learn if low-dose aspirin therapy is right for you.
These guidelines are only for “primary prevention” of heart disease. That means people who have not had heart disease in the past. If you already have heart disease, talk with your doctor to see if aspirin or some other blood thinner is advised to help prevent future heart attacks or strokes.
Reducing risk factors
Before you start aspirin therapy, talk to your doctor. Your doctor will look at all your personal risk factors when deciding if aspirin is right for you.
If you've already had a heart attack or stroke, your doctor may prescribe aspirin therapy to help prevent you from having another.
If you have not had a heart attack or stroke, but have certain risk factors, you may still be advised to take it. These risk factors include:
•High total cholesterol level
•A family history of heart disease
•High blood pressure
Early research suggests that aspirin may help prevent some cancers, but doctors don't recommend it for that purpose yet. More research is needed to see if any benefit would outweigh the risks.
Does aspirin therapy affect men and women differently?
One study showed that aspirin seems to be better at preventing a first stroke in women and a first heart attack in men. Men have a greater risk of having a heart attack than women until age 65.
The risk for women having a heart attack rises sharply after menopause. Plus, women are always at higher risk than men for having strokes. Both men and women face equal risks for stomach and intestinal bleeding from aspirin use.
What dose is safest and most effective?
Doctors are not sure what dose of aspirin is most effective to prevent heart attack or stroke. Higher doses may increase the risk of bleeding, but even at low doses there are still risks for:
•Ringing in the ears and hearing loss
If your doctor suggests aspirin therapy, ask what dose is right for you.
Potential drug interactions
Aspirin may interact poorly with other medications. For instance, ibuprofen and other anti-inflammatory medicines can block the effects of aspirin, and raise your risk for ulcers and bleeding by four times. Also, taking aspirin with other blood-thinning drugs can thin the blood too much. This can raise your risk of major bleeding complications.
If you take daily aspirin, talk to your doctor before any surgery, including dental work. You run the risk of excessive bleeding during surgery.
Finally, stopping aspirin may cause blood clots. Always talk to your doctor before you start or stop any medication, even over-the-counter ones.