— Judy, New Jersey
Many of my cardiology patients ask about the value of taking daily aspirin to prevent heart attack and stroke.
Recent research has shed new light on this. Indeed, mounting evidence
reported in a number of leading medical journals now suggests that if
you’re healthy and not at significant risk for a heart attack, you
should not be taking aspirin preventively. That’s because the studies
show that aspirin doesn’t reduce the risk of dying from a heart attack
or stroke in healthy people. Furthermore, the potential risk of a
cerebral hemorrhage, gastrointestinal bleeding, and ulcers outweighs any
heart benefits the aspirin might provide. Are you doing everything you can to manage your heart condition? Find out with our interactive checkup.
However, if you've already had a heart attack or stroke, or if you have been found by your doctor to be at high or moderate risk for heart attack or stroke, the benefits of taking aspirin can trump the risks. That’s because aspirin acts as an anti-inflammatory and an inhibitor of blood clotting. For those at risk, aspirin is one of the drugs in our arsenal (along with statins, ACE inhibitors, and beta blockers) that can help keep a coronary event from occurring in the first place or recurring.
As far as what dosage works best in people for
whom aspirin is recommended, I suggest you consult your own doctor.
Based on the new research, I no longer recommend aspirin (not even 81 mg
low-dose, or baby, aspirin) for any of my healthy patients, because the
risk of bleeding is two to four times greater than if you aren’t taking
aspirin at all. I do, however, continue to recommend 162 milligrams
daily (two low-dose aspirin) to patients who already have coronary heart
disease, have already had a heart attack or stroke, or who are at high
or moderate risk for one and not at risk for gastrointestinal bleeding.
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