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Learn about the effects of taking aspirin daily for heart health and if (and when) you should take it.

Can an aspirin a day keep the heart doctor away? Aspirin has been a mainstay in medicine cabinets for more than a century for its ability to relieve pain, reduce fever and combat inflammation. And in the last few decades, it has been celebrated for another remarkable benefit: Aspirin is a valuable ally in the fight against cardiovascular disease.

But while taking a low-dose aspirin daily can be lifesaving, it’s not for everyone. It can help lower your risk for a heart attack and stroke, but the benefits depend on your age, overall health and history of heart disease. The guidelines continue to change as researchers learn more about the benefits and risks of aspirin therapy. 

“For otherwise healthy people without a history of heart attack or stroke, the benefit of taking aspirin daily is debatable,” says Michael Kayal, DO, a Geisinger cardiologist. “But if you’ve already had one of these events and you have known heart disease, taking aspirin daily can be beneficial.” 

What is aspirin therapy?

Aspirin therapy involves taking one low-dose aspirin a day to safeguard heart health for people who either have had a heart attack or are at high risk of having one. 

“Aspirin belongs to a class of medications called nonsteroidal anti-inflammatory drugs (NSAIDs), which effectively manage inflammation and help prevent blood clots from forming,” explains Dr. Kayal. “Aspirin therapy has been shown to be very effective in reducing the risk of heart attacks and strokes, two of the leading causes of death in this country and worldwide.” 

Be sure to discuss with your doctor what aspirin dose is right for you. Dosage of aspirin to reduce the risk of a heart attack is lower than what’s typically needed for pain relief. A regular strength aspirin is 325 milligrams (mg), but low doses of aspirin — usually ranging between 75 to 100 mg, with 81 mg the most common low dosage — can be effective at preventing heart attack or stroke. 

Can aspirin prevent heart attacks?

A recent study in the American Heart Association Scientific Journals showed low-dose aspirin therapy reduces the risk of cardiovascular events by 21% and all-cause mortality by 13% in people with preexisting cardiovascular disease. 

Along with relieving pain, reducing inflammation and lowering fevers, aspirin thins your blood, which inhibits platelets’ ability to clump together and form dangerous blood clots. Blood clots are the leading cause of heart attacks and strokes.  

Most heart attacks occur when the blood supply to a part of your heart is blocked, which is usually the result of a buildup of plaque in your arteries. The more plaque, the more likely plaque rupture becomes. If the artery ruptures, it can cause inflammation and blood clots to form, which can block blood flow to parts of your body. 

“This is called an embolism,” says Dr. Kayal. “If the blood clot blocks blood flow to your heart, it can result in a heart attack.”

Should I take an aspirin during a heart attack?

If you have a heart attack, the first thing you should do is call 911. 

“The operator may recommend that you take an aspirin while you wait for the ambulance to arrive with medics,” says Dr. Kayal. “Chewing an aspirin tablet during a heart attack can prevent your blood from clotting, which could lessen the effects of a heart attack. Taking steps immediately is key to limiting the damage a heart attack can cause.” 

Taking an aspirin during a heart attack is safe and recommended. However, it’s not advised if you’re having a stroke because not all strokes are caused by blood clots. If a stroke is caused by a ruptured blood vessel, an aspirin could potentially make the bleeding more severe. 

Aspirin side effects and risks

Taking the occasional aspirin dose to relieve headaches, body aches or fever is safe for many adults. However, like most medication, aspirin has side effects and taking a daily dose of aspirin can cause serious complications, such as:

  • Stomach bleeding. Daily use of aspirin increases the risk of developing a stomach ulcer, which can lead to life-threatening bleeding. Drinking alcohol regularly can increase these stomach risks.
  • Stroke. While aspirin therapy can help prevent a clot-related stroke, it can increase the risk of a bleeding stroke. 
  • Kidney damage. Kidney damage is most likely to occur in people who already have kidney problems. Aspirin also can cause kidney stones in some people.
  • Allergic reaction. If you have an aspirin allergy or intolerance, taking any dose of aspirin can trigger a serious allergic reaction. 

“The benefits of taking aspirin every day must be carefully weighed against its risks,” says Dr. Kayal. “The risk of stomach bleeding increases with the dose of aspirin you take and the length of time you take it. Stomach bleeding can be serious, even fatal in some cases.”

Dr. Kayal also warns if you’re taking a daily aspirin, let your surgeon, doctor or dentist know before any procedures to help avoid excessive bleeding. 

Is taking aspirin daily recommended for heart health?

First and foremost, you should not take daily low-dose aspirin without talking to your doctor. Your doctor will consider your individual risk factors and medical history when making a recommendation about whether you should take aspirin daily.

The U.S. Preventative Service Task Force recently updated its guidelines for aspirin therapy and state:

  • Adults between ages 40 and 59 with a 10% or greater risk of having a first-time heart attack or stroke within the next 10 years may benefit from low-dose aspirin therapy.
  • Adults ages 60 and older may not benefit from low-dose aspirin therapy for the primary prevention of cardiovascular disease. The benefits of aspirin therapy decrease with age, while risks for complications, such as bleeding, increase.

If you’re otherwise healthy and don’t have a history of heart attack, taking a daily aspirin can lead to adverse side effects, such as stomach bleeding. This can be minimized by using the enteric-coated tablet, but it increases your risk of gastrointestinal bleeding. The benefits of taking a daily aspirin to prevent heart events don’t outweigh your risks of bleeding.

However, if you’re at a high risk for heart attack or stroke or if you’ve had either one, the benefits of daily aspirin therapy are greater than the bleeding risks to prevent another. Aspirin is part of a well-established secondary treatment plan for people with a history of heart attack or stroke. 

Significant risk factors for heart disease include: 

  • High blood pressure
  • High cholesterol
  • Family history of cardiovascular disease
  • Diabetes
  • Overweight or obese
  • History of smoking
  • Sedentary lifestyle

“Never stop aspirin therapy without talking to your doctor,” warns Dr. Kayal. “Stopping daily aspirin therapy suddenly may trigger a blood clot and lead to a heart attack.”

Heart-healthy lifestyle changes

Without taking aspirin daily, there are steps you can take to support your heart health and reduce your risk for cardiovascular disease, including:

  • Eating a heart-healthy diet. Reach for more fruits, vegetables, whole grains, lean meats and low-fat dairy, instead of sugary and salty snacks, saturated fats (butter, high-fat meats and dairy products) and trans fats (prepackaged foods, margarines and fried fast foods). 
  • Exercising regularly. The American Heart Association recommends at least 150 minutes of moderate exercise (brisk walking, swimming or biking) or 75 minutes of vigorous exercise (running or aerobics) each week, plus strength-training exercises at least two days a week.
  • Managing healthy blood pressure, cholesterol and blood sugar levels. Maintaining your heart-healthy numbers in a normal range plays a significant role in maintaining a strong heart. High blood pressure, cholesterol and blood sugar are all risk factors for heart disease and stroke.
  • Losing weight. Being overweight causes your heart to work harder. Plus, excess weight increases your risk for developing other heart disease risk factors, such as diabetes, high blood pressure, high cholesterol and sleep apnea. A healthy diet and active lifestyle are key to maintaining a healthy weight.
  • Quitting smoking. If you smoke, it’s never too late to quit. Chemicals in cigarette smoke lead to plaque buildup in the arteries. Quitting smoking can help improve circulation, lower blood pressure and decrease your risk for heart disease.

“Remember, you shouldn’t practice aspirin therapy on your own without first talking with your doctor,” says Dr. Kayal. “But, if recommended by your doctor, aspirin can help you get ahead of your heart health, in addition to a healthy lifestyle.”

Next steps: 

Learn more about heart care at Geisinger
See six heart symptoms you shouldn’t ignore
Learn the signs of a heart attack in women

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