Aspirin is one of the most common over-the-counter medications. But it’s not for everyone — not for daily taking at least.
Daily low-dose aspirin is often recommended for patients at high risk of heart attack or stroke. Daily use has risks that should always be weighed with your physician.
While many people take aspirin safely, daily use can cause bleeding in the stomach, intestines and brain, which can be life-threatening. Unless you are at risk of heart attack or stroke, you should not take aspirin daily.
Aspirin is also one of the oldest pain relievers. An occasional aspirin for headaches, body aches or fever is okay, but physicians nowadays recommend other more effective over-the-counter pain relievers.
“Daily aspirin has been shown to be helpful in lowering the risk of heart attack and stroke but it should never be taken without a doctor's recommendation,” says Sharifeh Kamalimotlagh, MD, an internal medicine physician at Scripps Clinic Carmel Valley. “People who are not at increased risk for bleeding and are willing to take low-dose aspirin daily are more likely to benefit.”
Aspirin is an anti-inflammatory or blood thinner that is taken to prevent blood clots, which can block the flow of blood through the arteries and lead to heart attack or stroke.
Physicians prescribe a daily low-dose aspirin to patients who have had a:
- Prior heart attack
- A stent implanted in the coronary arteries or legs
- Prior stroke
- Valve replacement
“People at high risk for heart attack or stroke can benefit taking aspirin daily to prevent blood flow problems that can result in a medical emergency,” Dr. Kamalimotlagh says.
Daily low-dose aspirin can also help people who have developed risk factors, such as high blood pressure and high cholesterol, but have not had a heart attack or stroke. This is known as primary prevention.
Making lifestyle changes to reduce the risk of heart disease is also a first line of prevention, including:
- Eating healthy
- Monitoring cholesterol, managing it if high
- Monitoring blood pressure, managing it if high
- Managing diabetes if present
- Not smoking
Aspirin is also considered a secondary prevention measure for people who’ve had a heart attack or stroke to prevent another attack.
The US Preventive Services Task Force, which updated its guidelines on the use of aspirin last year, says adults 40 to 59 who have a 10 percent or greater chance of heart disease may consider taking daily aspirin but should consult with their doctor first. The net benefit of daily aspirin is considered small for this age group. The risk of bleeding should always be discussed.
The task force recommends that adults 60 and older should not start taking aspirin to lower their risk of a first heart attack or stroke because the risks of bleeding can outweigh cardiovascular benefits. These recommendations don’t apply to people who already have established heart disease.
“If you have been prescribed aspirin by your doctor for any reason, don’t stop taking it without talking with them first,” Dr. Kamalimotlagh says.