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Healthy Living: Do you need a daily aspirin?

Healthy Living: Do you need a daily aspirin?


If you have had a stroke or heart attack, your health care provider may have recommended taking a low dose aspirin, or baby aspirin, regularly to help reduce your risk of another blood clotting event. But research shows that for people who haven’t had a heart attack or stroke, the benefit may not outweigh the risk of using aspirin as a preventative measure.

For patients who have already had a heart attack or stroke the benefits of aspirin in preventing a second event far outweigh the drawbacks. Because of the risk of gastrointestinal bleeding that can occur when using aspirin regularly, we seldom recommend it for people who don’t already have existing heart disease.

The American Heart Association reports that taking a daily aspirin following a heart attack can reduce the chance of a second heart attack by about 25 percent and a second stroke by 22 percent. That’s good news for those who are looking to prevent a second event.

However, a study published in the New England Journal of Medicine found that for people who have not had a heart attack but take a daily aspirin, the risk of a heart attack wasn’t significantly lower than the placebo group. The group that took the aspirin had a significantly higher risk of major bleeding.

Aspirin works by reducing inflammation and the clotting action of platelets in the blood. You appreciate these benefits when you take an aspirin for pain or if you’ve had a heart attack and want to lower your chance of having another blood clot. When taken over the long term, research reported in the American Journal of Medicine found that the way the drug interacts with the gastrointestinal lining of the stomach and intestines is damaging and can lead to inflammation, erosion, ulcers and bleeding.

Even coated aspirin — designed to delay dissolving until the small intestine — and buffered aspirin that is combined with an antacid carry risk of bleeding.

The current recommendations from the U. S. Food and Drug Administration, Centers for Disease Control and Prevention, and the American Heart Association reflect this bleeding risk and do not recommend aspirin as a primary prevention measure.

The medical community is realizing the importance of reducing cholesterol levels, weight and blood pressure, exercising and quitting smoking as key areas for preventing cardiovascular disease. If you are concerned about your risk of a heart attack, managing those aspects of your health are where you’ll see the most benefit.

While experts don’t recommend aspirin as a primary prevention measure for most people, there are some who may see a benefit despite the risk of bleeding. Those who are at the highest risk for having a heart attack — meaning those with high cholesterol, high blood pressure, diabetes, a strong family history and who smoke — and women who are at a high risk for stroke may lower their risk.

Most importantly, before beginning any aspirin therapy regimen, be sure and discuss it with your health care provider.

Matthew Barton, PA-C, is a physician assistant at Samaritan Cardiology in Corvallis.


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