Is Daily Aspirin Recommended?

Daily use can lower risk of heart attack or stroke, but it’s not for everyone

Patient holds an aspirin to help lower his risk of heart disease or stroke.

Daily use can lower risk of heart attack or stroke, but it’s not for everyone

Aspirin is one of the most commonly used over-the-counter medications. But it’s not for everyone — at least not for daily consumption.

Daily low-dose aspirin (81-100 mg) 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 may consider speaking with your physician about whether use of daily aspirin is appropriate for you.

Aspirin is also one of the oldest pain relievers. An occasional aspirin for headaches, body aches or fever has been used historically, 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, particularly in patients deemed at high-risk or who have suffered a prior cardiac or neurologic event. However, it should never be taken without a doctor’s recommendation,” says David Cork, MD, a cardiologist at Scripps Clinic Torrey Pines.

“People who are not at increased risk for bleeding and who have suffered prior cardiovascular or neurologic events are more likely to benefit from use of low-dose daily aspirin.”

Who needs aspirin?

Aspirin is an anti-inflammatory medication that inhibits platelet function. It can be taken to improve the flow of blood through the arteries and prevent 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 artery or lower extremity artery
  • Prior stroke or stroke equivalent
  • 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. Cork says.

Who else needs aspirin?

Daily low-dose aspirin can also help people who have developed risk factors, such as high blood pressure, high cholesterol, kidney disease, tobacco use, and diabetes, depending on the estimated cardiovascular risk. Patients with these risk factors may develop arterial calcification, which is a marker of atherosclerosis or hardening of the arteries. “Low-dose aspirin may help reduce the occurrence of a clinical event,” Dr. Cork says.

Making lifestyle changes to reduce the risk of heart disease is also a first line of prevention, including:

  • Eating healthy
  • Exercising
  • 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 U.S. 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.

Who should not take aspirin?

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. However, it may be useful to review recent clinical evidence and change in guidelines with your physician.” Dr. Cork says.

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