Should You Take an Aspirin Daily for Your Heart? (2024)

Taking aspirin every day can reduce the risk of heart attack and stroke. However, daily aspirin therapy is not suitable for everyone. Is it right for you?

The answer depends on your age, general health, history of heart disease and risk of heart attack or stroke.

Daily aspirin therapy can be used in two ways:

• Primary prevention.This means that you have never had a heart attack or stroke. You have never undergone coronary artery bypass surgery or coronary angioplasty with placement of a stent. You have never had clogged arteries in your neck, legs or other parts of your body. But you take an aspirin daily to avoid such heart problems. The benefit of aspirin for this use has been debated.
• Secondary prevention.This means that you have already had a heart attack or stroke, or that you have cardiovascular disease. You take an aspirin daily to prevent a heart attack or stroke. The benefit of daily aspirin therapy in this situation is well established.

Should you take an aspirin daily?

Do not start taking a daily aspirin without talking to your doctor. Taking an occasional aspirin or two is usually safe for most adults to use for headaches, body aches, or fever. But daily use of aspirin can have serious side effects, including gastrointestinal bleeding.

Talk to your healthcare provider about the pros and cons of daily aspirin therapy. Together you can discuss whether an aspirin a day can help prevent a heart attack or stroke.

As a person ages, the risk of heart attack and stroke increases. However, the risk of bleeding from aspirin increases even more. So:

• In people with a low risk of heart attackthe benefits of taking aspirin daily do not outweigh the risk of bleeding.
• The greater the risk of a heart attackthe more likely it is that the benefits of daily aspirin therapy will outweigh the bleeding risk.

Because of the risk of bleeding, some guidelines say that people age 60 and older without known cardiovascular disease should not start taking aspirin daily to prevent a first heart attack or stroke. However, the guidelines vary per organization. Other recommendations say to avoid starting daily aspirin therapy after age 70.

If you are between 60 and 69 years old, ask your healthcare provider how daily aspirin treatment may affect you.

Daily treatment with low-dose aspirin may be recommended for the primary prevention of heart attack or stroke if:

• You are between 40 and 59 years old and you are at high risk of having your first heart attack or stroke within the next 10 years. High risk means your risk is 10% or more.
• You have not had a heart attack, but you have had coronary bypass surgery or had a stent placed in a heart artery, or you have chest pain called angina, or another medical condition where aspirin has been shown to reduce heart attacks or prevents strokes.
• You are under 60 years old and you have diabetes and at least one other risk factor for heart disease, such as smoking or high blood pressure.

If you have had a heart attack or stroke, or if you have had heart disease, your doctor may recommend that you take a daily aspirin to prevent a heart attack or stroke, unless you have a severe allergy or a history of bleeding.

How can aspirin prevent a heart attack?

Aspirin affects how blood clots. When a person bleeds, clotting cells called platelets move to the wound site. The platelets help close the opening in the blood vessel. This stops the bleeding.

Sometimes such blood clots form in a damaged heart artery. The blood clot prevents blood flow to the heart and causes a heart attack. Having a condition called atherosclerosis increases your risk of these types of blood clots.

Because aspirin reduces the clotting effect, it is believed that daily aspirin therapy can prevent a heart attack.

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

Only take aspirin therapy daily if your healthcare provider tells you to. Before starting treatment with aspirin, tell your doctor about any health problems you have.

Daily aspirin therapy may not be a good choice if you:

• A bleeding or clotting disorder that causes you to bleed easily.
• An aspirin allergy, which may include asthma caused by aspirin.
• Bleeding peptic ulcer or a history of gastrointestinal bleeding.

What is the best dose of aspirin to take?

You and your healthcare provider can discuss what dose of aspirin is right for you. Low doses of aspirin -- such as 75 to 100 milligrams (mg), but usually 81 mg -- can be effective in preventing heart attacks or strokes. Healthcare providers usually prescribe a daily dose between 75 mg and 325 mg.

What happens if you stop taking aspirin daily?

If you are taking daily aspirin therapy, talk to your doctor before stopping it.

If you have had a heart attack or have had a stent placed in one or more of your heart arteries, it is important that you continue to take aspirin and any blood-thinning medications daily, just as your doctor has told you. If you suddenly stop taking aspirin daily, it could cause a blood clot and lead to a heart attack.

Can you take aspirin if you regularly take ibuprofen or a similar medicine?

Aspirin and medications such as ibuprofen (Motrin IB, Advil, others) and naproxen sodium (Aleve) can thin the blood. This can reduce blood clotting. Regular use of ibuprofen and naproxen sodium may increase the risk of bleeding. The drug, like aspirin, can also lead to ulcers. The risk of stomach ulcers increases significantly if you take aspirin and any of these other drugs together.

Ibuprofen and naproxen are medicines called nonsteroidal anti-inflammatory drugs (NSAIDs). CertainNSAID'sincrease the risk of heart attack. Take aspirin with someNSAID'sthe risk of bleeding may be even greater.

If you have a reason to take low-dose aspirin – such as a history of heart attack or bypass surgery –NSAID'scannot be used in place of aspirin to prevent heart attacks.

If you must take ibuprofen or similar medications, talk to your doctor about alternatives that won't interfere with daily aspirin therapy. For example, acetaminophen (Tylenol, others) may be an option.

What are the possible side effects of daily aspirin therapy?

Side effects and complications of taking aspirin daily include:

• Stroke caused by a burst blood vessel.Although daily aspirin can help prevent a blood clot-related stroke, it can increase the risk of a bleeding stroke. A bleeding stroke is also called a hemorrhagic stroke.
• Stomach bleeding.Daily use of aspirin increases the risk of developing stomach ulcers. If you already have a bleeding stomach ulcer or gastrointestinal bleeding, taking aspirin may cause more bleeding. The bleeding can be life-threatening.
• Allergic reaction.If you are allergic to aspirin, any dose of aspirin can cause a severe allergic reaction.

If you are taking aspirin and need surgery or dental work, tell the healthcare provider. You and your provider may need to take steps to prevent excessive bleeding. Do not stop taking aspirin without talking to your doctor.

What are possible drug interactions with daily aspirin therapy?

Sometimes a healthcare provider may recommend combining low-dose aspirin with a prescription blood thinner. Such combination therapy should always be discussed carefully. The combination can significantly increase the risk of serious bleeding.

Prescription blood thinners include:

• Apixaban (Eliquis).
• Dabigatran (Pradaxa).
• Enoxaparine (Lovenox).
• Heparin.
• Rivaroxaban (Xarelto).
• Warfarine (Jantoven).

Other drugs that may interact with aspirin and increase the risk of bleeding include:

• Clopidogrel (Plavix).
• Corticosteroids.
• Ibuprofen (Advil, Motrin IB, others) with regular use.
• Some antidepressants, such as clomipramine (Anafranil) and paroxetine (Paxil, Brisdelle, Pexeva).

Certain herbal and nutritional supplements can also increase the risk of bleeding when combined with aspirin. These include:

• Blueberry.
• Capsaicin.
• Cover the room.
• Danshen.
• Night light oil.
• Ginkgo.
• Kava.
• Ma-huang.
• Omega-3 fatty acids (fish oil).

Drinking alcohol during daily aspirin treatment may increase the risk of stomach bleeding. Discuss with your doctor how much alcohol you can safely drink. If you choose to drink alcohol, do so in moderation. For healthy adults, this means a maximum of one drink per day for women and a maximum of two drinks per day for men.

If you take aspirin daily, is it still safe to take an aspirin during a heart attack?

Yes. Taking aspirin during a heart attack is safe and recommended. If you think you are having a heart attack, call 911 or 911. Don't wait to get help. Aspirin alone will not save your life if you have a heart attack.

When you call for help, the 911 operator may ask you to chew an aspirin. The operator will first ask if you have an aspirin allergy or other health problems that make it unsafe to take an aspirin. It's fine to chew an aspirin if your healthcare provider has told you to do so before if you think you are having a heart attack, but always call 911 or 911 first.

Should You Take a Coated Aspirin?

Coated aspirin is also called enteric-coated aspirin. It is made to pass through the stomach and only dissolve when it reaches the small intestine. Coated aspirin may be gentler on the stomach. It may be suitable for some people who take aspirin daily, especially those with a history of gastrointestinal infections or ulcers.

But there is no evidence that taking coated aspirin reduces the risk of gastrointestinal bleeding. Also, coated aspirin may not work as well as regular aspirin when taken at the time of a possible heart attack. Talk to your doctor if you are concerned about how to reduce the risk of bleeding.

20 april 2023

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