Does an Aspirin a Day Keep Heart Attacks Away?
For years, a pearl of common wisdom has been that taking a daily low-dose aspirin is a safe and effective way to help prevent heart attacks and strokes among older adults.
While recent research confirms that this is true for many patients, the same studies also reveal an increased risk of major internal bleeding for others.
So, who should take aspirin every day and who should stop?
It all depends on your medical history.
Researchers and doctors agree. People with a history of certain cardiovascular issues should continue their daily aspirin regimen (if recommended by their cardiologist). Doing so will help prevent another life-threatening episode. This applies to those who have survived a heart attack or stroke, and those with a stent or peripheral artery disease.
“But, the evidence for aspirin in primary prevention (of a first heart attack or stroke) is quite weak,” explains Dr. Carl Orringer, a cardiologist with the University of Miami Health System who specializes in preventive care. In fact, “One of the three recent studies looked specifically at those age 70 and older without a history of cardiovascular problems. Aspirin did not clearly benefit those patients. It actually led to a higher mortality rate for the healthy adults taking aspirin compared to placebo.”
The findings show aspirin use is associated with a significantly increased risk of major bleeding, including intracranial and gastrointestinal bleeding.
“The conclusion is aspirin doesn’t appear to have significant benefit, yet maybe some harm, for older adults without a history of cardiovascular issues,” Dr. Orringer says.
These large trial studies have really changed the way we’re looking at aspirin for prevention.Dr. Orringer
Based on an assessment of your medical condition and history, your doctor may advise you to start, stop, or continue a daily aspirin regimen. But, there are other interventions and lifestyle choices you can make to reduce your risk for a cardiovascular event or cerebrovascular accident.
“For all patients, regardless of cardiovascular risk, we always recommend a healthy lifestyle,” says Dr. Orringer.
“Smoking cessation makes a major difference for heart attack, stroke, and cancer risks. Eating a heart-healthy diet and doing regular cardio exercise reduce your risk over time.”
For people with an increased risk of cardiovascular disease or cardiac death, doctors continue to prescribe cholesterol-lowering drugs called statins and blood pressure management drugs.
“These can provide significant benefit, depending on the patient’s projected future risk of heart attack and stroke,” Dr. Orringer says.
“For secondary prevention (of another heart attack or stroke), those measures are just part of what we do for patients. For those with a history of heart disease, stroke, or blocked arteries in the legs, we recommend a combination of medical treatments to reduce their future risk. And, if you already have cardiovascular disease, aspirin does seem to help.”
Dana Kantrowitz is a contributing writer for UMiami Health News.