An aspirin a day may not be the best way to avoid heart disease and stroke

October 15, 2021 | by Edward-Elmhurst Health
Categories: Healthy Driven Hearts

For years, physicians have recommended some adults take an aspirin a day in late middle age to reduce their risk of a heart attack or stroke.

Aspirin, a blood thinner, can help prevent heart attack and stroke (also known as cardiovascular disease) by preventing blood clots from forming in blood vessels that carry blood to the heart and brain.

In 2016, the U.S. Preventive Services Task Force (USPSTF) recommended a daily aspirin to reduce the risk of a first heart attack or stroke. But new evidence shows a daily aspirin may do more harm than good, especially in people age 60 and older.

The task force recently reversed its recommendation for certain individuals to take a daily aspirin to help prevent cardiovascular disease.

“The most serious potential harm a daily aspirin can cause is bleeding in the stomach, intestines and brain,” the group said in its statement. “The chance of bleeding increases with age and can be life-threatening.”

The task force does not recommend that people age 60 and older begin taking aspirin to prevent heart attack or stroke, and says people age 40 to 59 should talk with their doctor before starting a daily aspirin regimen to assess whether the benefit outweighs the risk.

“The group of patients this applies to are people who don’t have a history of heart attack or stroke,” says John Cahill, M.D., an interventional cardiologist with Midwest Cardiovascular Institute and on the medical staff at Elmhurst Hospital. “People who have already had overt heart disease such as a bypass, heart attack or implantation of a coronary stent clearly benefit from taking an aspirin, and the benefit far outweighs the risk.”

This task force recommendation applies only to those who are at a higher risk for cardiovascular disease, have no history of cardiovascular disease and are not already taking daily aspirin.

“People in that category who are already taking an aspirin a day should not stop taking it but should consult with their doctor in light of this new recommendation,” says Dr. Cahill.

There is a growing number of people who have some plaque blockage that may show up on a heart scan, but it’s not severe enough to warrant a stent or cause a heart attack. Would aspirin help them?

“The guidelines don’t really address this group of patients. Would those people, who we know have early plaque, benefit from aspirin? I would recommend it, but it’s something they should discuss with their doctor,” says Dr. Cahill.

Fortunately, there are ways to lower your risk of heart attack and stroke that don’t involve a daily aspirin, says Dr. Cahill.

“Being aware of your blood pressure and working with a doctor to get it under control if necessary is important,” he says. “Other illnesses that can increase your risk, such as diabetes or high cholesterol, are treatable and should be treated aggressively to lower the risk of heart attack.

“For everyone, eating a healthy diet and regular exercise are the bedrock of preventive care,” Dr. Cahill says.

Your heart is in expert hands when you choose Edward-Elmhurst Heart Hospital for your cardiovascular care. Learn more about cardiovascular care at Edward-Elmhurst Health.

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