Should I take aspirin to prevent heart disease?

September 9, 2019

Providence Heart & Vascular Team

Millions of people take aspirin to prevent heart attacks, but new research shows it may cause more harm than good.

[3 MIN READ]

For many years, doctors recommended taking low-dose aspirin for its blood-thinning properties to help prevent heart attacks. But recent research shows that a daily aspirin regimen may only benefit a small group of adults.

In fact, for some people, taking aspirin every day may cause more harm than good.

If you’ve never had a heart attack or stroke, taking low-dose aspirin will not prevent cardiovascular disease. However, if you’ve already had a heart attack or stroke, daily aspirin is recommended. Read on to learn the difference.

Why aspirin?

Most heart attacks and strokes are caused by a buildup of plaque in the arteries, also called atherosclerosis. This plaque is made up of fatty substances like cholesterol.

When plaque builds up, it can reduce blood flow through the arteries. What’s more dangerous is when pieces of plaque break off creating blood clots that block the flow to the heart (causing a heart attack) or the brain (causing a stroke).

Aspirin helps prevent blood clots from forming by thinning your blood and keeping it moving properly through your arteries.

You may have heard that taking aspirin while you are having a heart attack can slow the progression and stop it from happening.

You may have heard that taking aspirin while you are having a heart attack can slow the progression and stop it from happening. However, if you or someone you are with is experiencing heart attack symptoms, it’s crucial to first call 911 — the operator may advise you to take an aspirin. Your medical team can also help you determine if an aspirin is safe to take based on your condition.

Taking aspirin during a stroke is not safe, as it can sometimes cause more bleeding in the brain.

What the research says

Three studies released in 2018 showed that aspirin had no benefit for healthy adults in primary prevention of cardiovascular disease.

“Low-dose” aspirin means a dosage of 75-100mg a day.

The studies that looked into aspirin use include:

ASPREE (Aspirin in Reducing Events in the Elderly)
ARRIVE (Aspirin to Reduce Risk of Initial Vascular Event)
ASCEND (A Study of Cardiovascular Events in Diabetes)

One study showed that people over the age of 70 had a “significantly higher risk of a major hemorrhage” when using low-dose aspirin every day, as bleeding risk increases with age.

The trials also showed that taking aspirin every day actually increased the risk of serious side effects, like internal bleeding, as it reduces your blood’s ability to clot. One study showed that people over the age of 70 had a “significantly higher risk of a major hemorrhage” when using low-dose aspirin every day, as bleeding risk increases with age.

The new guidelines

As a result of the recent research, the American Heart Association and American College of Cardiology have changed their guidelines on aspirin use. Here’s what they say:

Adults age 70 and older should not take low-dose aspirin to prevent cardiovascular disease.
Adults of any age who have an increased risk of bleeding should not take low-dose aspirin to prevent cardiovascular disease.
Adults age 40-70 who are at an increased risk for cardiovascular disease may take low-dose aspirin if they do not have an increased risk for bleeding. These adults should only follow an aspirin regimen if instructed by their doctor.

“In adults aged 70 years or older, the current evidence for use of aspirin therapy for prevention of cardiovascular disease is insufficient. There is no balance of evidence to suggest initiating aspirin to prevent cardiovascular disease in adults age 70 years or older.” -- Daniel Eisenberg, M.D., Providence Medical Institute

Other ways to stay heart healthy

For most healthy adults, low-dose aspirin isn’t recommended when it comes to heart disease prevention. But what else can you do to stay heart healthy? Here’s what the American Heart Association recommends:

Eat a healthy, plant-based diet that includes lots of fruits and vegetables, nuts and whole grains. Avoid trans fats and saturated fats, limit red and processed meat, and stick to small portions of lean proteins, like chicken. [link to August article on white meat].
Exercise regularly. Adults should aim for 150 minutes of moderate-level activity each week, like walking, or 75 minutes of vigorous activity, like running.
Don’t smoke. If you need help quitting, talk to your doctor about healthy ways you can quit.

If you want more information on how to lower your risk for cardiovascular disease, talk with your doctor about preventive steps you can take.