Daily aspirin therapy: Understand the benefits and risks
Daily aspirin therapy can be a lifesaving option, but it's not for everyone. Get the facts before considering a daily aspirin.By Mayo Clinic Staff
Daily aspirin therapy may lower your risk of heart attack, but daily aspirin therapy isn't for everyone. Is it right for you?
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 will likely 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.
How can aspirin prevent a heart attack?
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.
Should you take a daily aspirin?
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 use of aspirin to prevent heart attacks in people with diabetes but no other risk factor is controversial.
The U.S. Preventive Services Task Force recommends daily aspirin therapy if you're age 50 to 59, 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.
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
What's the best dose of aspirin to take?
Your doctor will discuss what dose is right for you. Very low doses of aspirin — such as 75 to 150 milligrams (mg), but most commonly 81 mg — can be effective. Your doctor will usually prescribe a daily dose anywhere from 75 mg — the amount in an adult low-dose aspirin — to 325 mg (a regular strength tablet).
If you have had a heart attack or have had a heart stent placed, it's very important to take aspirin and any other blood-thinning medications exactly as recommended.
What happens if you stop taking aspirin every day?
You might be surprised to learn that stopping daily aspirin therapy can have a rebound effect that may increase your risk of heart attack. If you have had a heart attack or a stent placed in one or more of your heart arteries, stopping daily aspirin therapy can lead to a life-threatening heart attack.
If you have been taking daily aspirin therapy and want to stop, it's important to talk to your doctor before making any changes. Suddenly stopping daily aspirin therapy could have a rebound effect that may trigger a blood clot.
Feb. 21, 2018
See more In-depth
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