An Aspirin a Day–Maybe Not

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For many years, healthy adults have been taking an aspirin a day to reduce their risk of heart disease and common types of cancer. In April 2016, the U.S. Preventive Services Task Force recommended a low-dose aspirin daily for healthy adults over the age of 50. But in October 2018, a large study published in the New England Journal of Medicine, involving nearly 20,000 people 65 and older changed the recommendation.

Dr. Daniel Courtade, Cardiologist at the St. Elizabeth Heart and Vascular Institute offers advice to help you weigh the benefits and risks of taking a daily low-dose aspirin.

Should I Take a Low-Dose Aspirin Every Day?

“If you are healthy and aren’t at risk for a heart attack the answer is NO,” says Dr. Courtade. The study showed the risks associated with taking a daily low-dose aspirin outweigh the benefits for healthy older people.

“If you are over 65 and at risk for a heart attack, then the short answer is YES,” added Dr. Courtade.

How Do I Know if I Have an Elevated Risk for a Heart Attack?

Dr. Courtade points out an important aspect of the recent study, “The study still shows a benefit for older people with an elevated risk. But, the only way to understand your risk profile is to talk to your healthcare provider. A number of factors determines the guidelines for what is considered at risk.”

Factors that help a provider determine risk include:

  • If you have already suffered a heart attack or stroke.
  • If you have had bypass surgery or a stent placed in an artery.
  • If you have carotid artery disease or peripheral arterial disease.
  • If you have family history of a heart attack.

How Does an Aspirin Help my Heart?

When you have heart disease, cholesterol can build up on the walls of your arteries. These cholesterol deposits can cause inflammation that produces plaque, causing your artery to narrow or become blocked. When you have a heart attack, the plaque in the artery cracks or ruptures. Blood cells then stick to the plaque and form a clot, which blocks the artery completely. Taking a daily aspirin can stop the blood cells from sticking together and forming the clot.

What are the Risks of Taking a Baby Aspirin?

“This large study shows that if you are healthy, over the age of 65, and don’t have an increased risk for heart or stroke, the risks associated with taking a low-dose aspirin outweigh the benefits,” says Dr. Courtade.

The risks associated with a daily baby aspirin for a healthy person over the age of 65 include:

  • A major bleeding event (long-term aspirin use acts as a blood thinner).
  • Stroke.
  • Heart failure.
  • Higher rate of cancer-related death.

Should I Stop Taking My Daily Low-Dose Aspirin Before Surgery?

This is very specific to the patient and the surgery. If you are taking a daily aspirin, talk to your doctor before any scheduled procedure.

Should I Take an Aspirin if I am Having Symptoms of a Heart Attack?

If you begin having symptoms of a heart attack, call 911 and take four low-dose aspirin. It is also important to tell the emergency medical personnel that you took aspirin prior to their arrival.

What if I am Allergic to Aspirin?

A true allergy to aspirin is rare. If you break out in a rash or have swelling after taking an aspirin, discontinue use immediately and talk to your doctor. There are alternative prescription medications you can use if you do not tolerate aspirin.

If you are considering taking a low-dose aspirin, talk to your primary care physician or your cardiologist. If you have heart disease and would like to find a cardiologist near you, call St. Elizabeth at (859) 301-HERE.