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Aspirin do’s and don’ts
Assessing your risk
Who should take daily aspirin?
Who should NOT take aspirin?

Aspirin action
Aspirin action

Aspirin works by reducing the stickiness of your blood’s platelets, keeping them from clumping together and preventing blood clots from forming. Researchers continue to study aspirin to determine the best dose for heart benefits, but your doctor will likely prescribe a daily or every-other-day dose of between 81 mg (baby aspirin) and 325 mg (regular adult strength). Higher doses can increase unwanted side effects and don’t necessarily offer greater heart protection.

Since the creation of aspirin about 100 years ago, millions of people have used this medicine-cabinet staple to treat headaches, fevers and minor aches and pains. In recent decades, scientists found that aspirin’s blood-thinning effects can help to prevent heart attacks and clot-related strokes, making it a low-cost wonder drug for many heart patients.

So why isn’t everyone taking it? Contrary to what TV ads may lead you to believe, taking aspirin every day, known as aspirin therapy, is not for everybody. Regular use can cause unwanted side effects like stomach bleeding, bleeding in the brain, kidney failure and allergic reactions.

Assessing your risk

Talk to your doctor about whether you should consider aspirin therapy. The decision will come down to whether your personal risk for a heart attack or stroke is greater than your risk for other health problems aspirin therapy may bring. To measure your risk, your doctor will consider such factors as your age, family history, cholesterol, blood pressure, weight, smoking habits and activity level.

Who should take daily aspirin?

Your doctor may suggest aspirin therapy for you if:

  • You’ve had a heart attack or stroke. Aspirin benefits patients who have suffered a heart attack, angina, ischemic stroke (caused by blood clot) and mini-stroke or have undergone coronary bypass surgery or angioplasty. Research shows aspirin can help prevent a second heart attack or stroke or hospitalization for angina.
  • You’re a man over age 40. Everybody’s risk increases with age, but men are more likely to suffer a heart attack at an earlier age than women.
  • You’re a postmenopausal woman. The hormone estrogen has a protective effect on the heart. But when estrogen levels plummet after menopause, a woman’s heart risk increases significantly. The American Heart Association’s new guidelines recommend low-dose aspirin therapy be considered for all women ages 65 and older, even those with no other risk factors.
  • You have major risk factors. You’re at risk if you have high cholesterol, high blood pressure, diabetes or a history of smoking.

Who should NOT take aspirin?

People at low risk for heart attack or stroke generally do not benefit from aspirin therapy because the dangers from potential side effects outweigh the heart benefits. Even if you’re at high risk for heart disease, other health conditions can make serious side effects like gastrointestinal upset or bleeding more likely and outweigh the potential heart benefits. People who take aspirin regularly should not drink alcohol. Aspirin therapy may be a bad choice for you if you have other medical concerns such as:

  • pregnancy
  • uncontrolled high blood pressure
  • bleeding disorders
  • asthma
  • stomach ulcers
  • liver or kidney disease

If you have a high heart attack risk but cannot or should not take aspirin, your doctor may prescribe other antiplatelet or blood-thinning drugs instead. Because aspirin is a common household item, it can be easy to forget the little tablet is a drug. If your doctor advises you to begin aspirin therapy, take it exactly as prescribed. Be sure to ask about special precautions you may need to take before undergoing dental work or surgical procedures and never stop aspirin therapy unless directed by your doctor.