Belmont Medical Associates

Heart Health

Aspirin for Heart Health and Stroke Prevention

Aspirin is a "blood-thinning" medication that may be recommended for once-a-day use to maintain heart health and reduce the risk of stroke.

If you've had a heart attack or stroke, or at high risk of having a heart attack or stroke, your doctor may talk to you about taking daily aspirin. Antiplatelet drugs, such as aspirin, can help prevent a variety of potentially life-threatening conditions, including:

  • stroke - caused by bleeding or blood clots in the brain
  • heart attack (myocardial infarction) - caused by blood clots in the heart
  • pulmonary embolism (PE) - caused by blood clots in the lungs
  • deep vein thromboses (DVTs) - caused by blood clots in the veins of the legs.

Research shows that for men who have had a heart attack, taking aspirin daily can lower the risk of a second heart event by 20-30%. It also reduces the risk of a recurrent stroke among women who have had a stroke caused by a blood clot (ischemic stroke).

However, not everyone benefits from daily aspirin use and there are risks to taking aspirin every day, such as an increased risk of gastrointestinal bleeding.

Your doctor will recommed daily aspirin use depending on several factors, including

  • Your age. People over 50 or 60 years old are more likely to benefit from daily aspirin use.
  • Your gender. Aspirin has different effects for men and women
  • History of heart disease. Having already had a stroke, heart attack, or other cardiovascular event increases the likelihood that aspirin would provide benefit.
  • Other medical conditions. Some medical conditions increase the likely benefit of daily aspirin use, while others increase its risks.

For people without heart disease, guidelines from the United States Preventive Services Task Force and other national groups say aspirin therapy should be decided case by case, depending on the individual’s risk factors and family history.

For people who have diabetes, the American Diabetes Association (ADA) recommends a low-dose aspirin only for men older than 50 and women older than 60 who have at least one additional risk factor for heart disease, such as smoking, family history of heart disease, high cholesterol or high blood pressure.

Daily aspirin may not be recommended for individuals with conditions that could increase their risk of bleeding or other medical complications, such as:

  • A bleeding or clotting disorder
  • Asthma
  • Stomach ulcers
  • Heart failure

TELL YOUR DOCTOR IF YOU ARE TAKING DAILY ASPIRIN.

DO NOT TAKE DAILY ASPIRIN WITHOUT FIRST TALKING TO YOUR DOCTOR ABOUT THE RISKS AND BENEFITS.

How Does Aspirin Work to Prevent Heart Attacks or Stroke?

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is categorized as an "antiplatelet" drug that slows down the activity of blood cells called platelets. Platelet stick to damaged areas inside blood vessels and start the formation of blood clots.

In blood vessels narrowed by heart disease, fatty deposits can burst, leading to the quick formation of a clot that blocks the flow of blood to the heart or brain. Regularly taking an aspirin helps prevent the clot from forming.

(Magnified image of platelets clumping together in a damaged area of the blood vessel and starting to form a clot.)

Daily Aspirin Dosage

You and your doctor will discuss what dose of aspirin is right for you.

Your doctor may prescribe a daily dose ranging from 81 mg (the amount in a baby aspirin) to 325 mg (regular strength).

Very low doses of aspirin (75 mg) may also be recommended for some people.

Complications of Aspirin Use

  • Hemorrhagic stroke. Daily aspirin use can help prevent a clot-related stroke (ischemic stroke), but it can increase a person's risk of having a bleeding stroke (hemorrhagic stroke).
  • Gastrointestinal bleeding. Daily aspirin use increases a person's risk of developing a stomach ulcer.
  • Allergic reaction. If you're allergic to aspirin, taking any amount of aspirin can trigger a serious allergic reaction.

Precautions When Taking Daily Aspirin

  • Dental work or surgical procedures. Aspirin use can increase the risk and severity of bleeding during and after surgery or dental procedures. Be sure to tell the dentist or surgeon if you are taking aspirin and how much.
  • Stopping aspirin. Stopping daily aspirin use can have a rebound effect and increase a person's risk for developing a heart attack or stroke. Talk to your doctor before stopping daily aspirin therapy.
  • Taking ibuprofen. Taking ibuprofen can increase your risk of bleeding. If you need only a single dose of ibuprofen for pain relief, take it 8 hours before or 30 minutes after the aspirin. Talk to your doctor about alternative forms of pain relief if you need to take ibuprofen more often.
  • Alcohol use. The FDA warns that people who regularly take aspirin should limit the amount of alcohol they drink because of its additional blood-thinning effects and the increased risk of gastrointestinal upset and bleeding. If you take aspirin daily, you should not have more than one drink a day if you're a woman or two drinks a day if you're a man.
  • Other medications. Some medications can increase a person's chance of bleeding when combined with aspirin. Let your doctor know if you are taking any of the following medications: warfarin (Coumadin), heparin, ibuprofen (Advil, Motrin) corticosteroids, some antidepressants (clomipramine, paroxetine, others)
  • Herbal remedies and supplements. Over-the-supplements and herbs can increase a person's chance of bleeding when combined with aspirin. Let your doctor know if you are taking any of the following dietary supplements or herbs, including dong quai, evening pimrose oil, ginkgo, omega-3 fatty acids (fish oil), policosanol, willow bark.

Alternatives to Daily Aspirin

Aspirin has been available for many years and its safety and efficacy have been shown in many medical studies. However, not all people can tolerate aspirin or benefit from its effects and other antiplatelet drugs are available that may be considered to prevent clotting in special circumstances, such as following a stent.

New antiplatelet drugs include clopidogrel (Plavix®), prasugrel (Effient®), ticagrelor (Brilinta®), ticlopidine (Ticlid®), cilostazol (Pletal®).