Taking a Daily Aspirin To Prevent a Heart Attack or Stroke? Think Twice.

blood pressure meter and heart
Benita Lee
Benita Lee, MPH, is on the Research Team at GoodRx.
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People often recommend an aspirin a day as an easy way to prevent heart attacks and strokes, but as it turns out, daily aspirin might not be good for everyone. A study in the Journal of the American College of Cardiology reports that at least 12% of  people taking aspirin once a day don’t need to be. Here’s how to weigh the risks and benefits.

Benefits of aspirin

Aspirin is famously known as an NSAID (non-steroidal anti-inflammatory drug) that can be used for pain, fever, headache, and inflammation. It also thins the blood and makes it run more smoothly through the body, which is why people use it for heart attack and stroke prevention.

To be sure, after someone suffers a heart attack or stroke, taking an aspirin a day can help prevent another such event from happening. But whether an aspirin can help prevent someone from having a heart attack or stroke in the first place is still hotly debated.

Potential side effects of aspirin

Although aspirin is available over the counter, it’s still a medication with potentially serious side effects. For instance, taking aspirin daily can increase the risk for bleeding in the gut. Too much aspirin can irritate the lining of your stomach and intestines, making it more prone to bleeding. This can be quite serious and require a blood transfusion to replace all the blood that was lost.

Who else should be concerned? People with certain health conditions or taking specific medications should avoid aspirin. For example, people with kidney or liver disease should not be taking aspirin. Also, those with high blood pressure should avoid it because of an increased risk of hemorrhagic stroke — if a patient with high blood pressure takes aspirin and has a stroke (or a ruptured blood vessel in the brain), they may experience uncontrolled bleeding because their blood won’t clot.

When does aspirin help for heart attacks and stroke?

First, aspirin should be taken during a heart attack. In fact, it’s crucial. One estimate claims that people are more than 20% less likely to die from a heart attack if they take an aspirin, the earlier the better. For first aid during a heart attack, take a 325 mg aspirin pill that is not enteric-coated and make sure to chew it before swallowing it with a glass of water. This way, the aspirin will reach your system quickly.

For preventing heart attacks and stroke, the American Heart Association recommends daily low-dose aspirin only to people with a high risk of having a heart attack or to people who have already had a heart attack. The US Preventive Services Task Force further defines “high risk” as adults of at least 50 years of age who have a 10% or greater risk for have a heart attack or stroke within the next 10 years. These adults should not have an increased risk of bleeding, should have a life expectancy of at least 10 years, and should be willing to take a low-dose aspirin daily for at least 10 years. 

The reported safe range for aspirin dosing is quite wide, with people taking anywhere between 50 and 325 mg per day. Due to potential risks like internal bleeding, always consult your doctor before taking an aspirin every day. Other factors like heart disease risk, high cholesterol, high blood pressure, other medications, and smoking status should also be taken into account. 

Interested in what your 10-year risk of heart disease might be? Try this online calculator.

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