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aspirin benefits risks and recommendations

If you’ve had a heart attack or stroke, your doctor will likely recommend you take a daily aspirin unless you have a serious allergy or history of bleeding. If you have a high risk of having a first heart attack, your doctor might recommend aspirin after weighing the risks and benefits.

You shouldn’t start daily aspirin therapy on your own, however. While taking an occasional aspirin or two is safe for most adults to use for headaches, body aches or fever, daily use of aspirin can have serious side effects, including internal bleeding.

Aspirin interferes with your blood’s clotting action. When you bleed, your blood’s clotting cells, called platelets, build up at the site of your wound. The platelets help form a plug that seals the opening in your blood vessel to stop bleeding.

But this clotting can also happen within the vessels that supply your heart with blood. If your blood vessels are already narrowed from atherosclerosis — the buildup of fatty deposits in your arteries — a fatty deposit in your vessel lining can burst.

Then, a blood clot can quickly form and block the artery. This prevents blood flow to the heart and causes a heart attack. Aspirin therapy reduces the clumping action of platelets — possibly preventing a heart attack.

Talk with your doctor about whether daily aspirin therapy might help you prevent a heart attack. Your doctor may suggest daily aspirin therapy if:

You’ve already had a heart attack or stroke
You haven’t had a heart attack, but you have had a stent placed in a coronary artery, you have had coronary bypass surgery, or you have chest pain due to coronary artery disease (angina)
You’ve never had a heart attack, but you’re at high risk of having one
You have diabetes and at least one other heart disease risk factor — such as smoking or high blood pressure — and you’re a man older than 50 or a woman older than 60
The U.S. Preventive Services Task Force recently recommended daily aspirin therapy if you’re age 50 to 59 years, you’re not at increased bleeding risk, and you have an increased risk of heart attack or stroke of 10 percent or greater over the next 10 years. If you’re age 60 to 69, you aren’t at increased bleeding risk, and you have a high risk of heart attack or stroke of 10 percent or greater over the next 10 years, talk to your doctor about daily aspirin therapy. More research is needed to determine the benefits and risks of daily aspirin use in adults younger than age 50 and older than age 70 before a recommendation can be made for or against aspirin use to prevent cardiovascular disease and colorectal cancer for these age groups.

Although aspirin has been recommended in the past for certain groups of people without a history of heart attack, there’s some disagreement among experts about whether the benefits of aspirin outweigh its potential risks. The Food and Drug Administration doesn’t recommend aspirin therapy for the prevention of heart attacks in people who haven’t already had a heart attack, stroke or another cardiovascular condition.

Guidelines are varied between organizations, but they’re evolving as more research is done. The benefits of daily aspirin therapy don’t outweigh the risk of bleeding in people with a low risk of heart attacks. The higher your risk of heart attack, the more likely it is that the benefits of daily aspirin outweigh the risk of bleeding.

In women, daily aspirin therapy may be more effective at preventing strokes than heart attacks. The bottom line is that before taking a daily aspirin you should have a discussion with your doctor.

Should you avoid daily aspirin therapy if you have another health condition?

Before starting daily aspirin therapy under the advice of your doctor, you should let him or her know if you have a health condition that could increase your risk of bleeding or other complications. These conditions include:

A bleeding or clotting disorder (bleeding easily)
Aspirin allergy, which can include asthma caused by aspirin
Bleeding stomach ulcers