Daily Aspirin for Heart Health—Is It Saving or Harming You?

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If you are taking aspirin every day to ward off heart attack and stroke, just like more than one-third of Americans do, you may actually be putting yourself in harm’s way. Some doctors may not even be following long-known guidelines about who should and shouldn’t be taking daily aspirin! Learn more about whether you yourself do need an aspirin a day to keep a heart attack away…or whether taking it might land you in the hospital or worse.

WHO NEEDS IT?

Aspirin is a blood thinner that helps prevent artery-blocking clots. But the same anticlotting mechanism that can prevent heart attacks and strokes can cause serious and deadly internal bleeding in the form of stomach ulcers and bleeding in the brain.

While daily aspirin has been shown to reduce risk of heart disease and ischemic stroke in people with heart disease, risk of hemorrhagic stroke is very slightly increased. Meanwhile, studies have shown that people who take daily aspirin but do not have heart disease have a 30% increased risk of internal bleeding (including deadly hemorrhagic stroke) compared with healthy people who do not adopt this regimen.

So, the only people who should be taking daily aspirin are those in whom its cardiovascular benefits outweigh its health risks. These people include those who already have had a heart attack or stroke and those at medium-to-high risk for having one. But researchers from Baylor College of Medicine in Texas discovered that about one in 10 people who take daily aspirin are not in these categories.

They found this out by analyzing five years’ of medical records from 119 cardiology practices across America. This allowed them to identify nearly 69,000 patients who were taking daily aspirin even though they never had had a heart attack or stroke. Although most of these patients were at medium-to-high risk for these deadly cardiovascular events, roughly 12% were at low risk and, therefore, should not have been taking daily aspirin. Risk factors for heart attack and stroke can include a family history, older age, smoking, and, of course, high blood pressure, high cholesterol, obesity, physical inactivity and diabetes. Level of risk hinges on the number and severity of risk factors a person has.

When the researchers looked into how aspirin was being prescribed to patients, they found a lot of variation. The percentage of inappropriate aspirin prescriptions per cardiology practice ranged from 0% to 72%.

TAKE CHARGE!

This study looked at people who took aspirin who were under the care of cardiologists, but how many of you are taking daily aspirin because your primary care doctor told you to or because you simply read somewhere that it was a good idea? Many more people than those identified in the study are probably risking gut ulcers and deadly brain bleeds by taking aspirin they don’t need.

You may be able to know whether the benefits of aspirin outweigh the risks for you personally without first consulting a doctor. If you already know your blood pressure levels and either your cholesterol level or body mass index,  you can calculate your cardiovascular disease risk with the same calculator used in the study. After you click on the link, find where it says “Risk Score Calculators” on the Web page and select either the calculate-by-BMI or calculate-by-lipids option. If your 10-year risk of cardiovascular disease is below 6%, then you may be better off avoiding an aspirin-a-day. If higher, then it is best to talk to your doctor about whether the benefits of daily aspirin to prevent cardiovascular disease outweigh the risks. But be sure your doctor engages with you on the pros and cons and doesn’t just push the aspirin right at you.