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Aspirin Therapy: Right for Your Heart?

Daily aspirin helps many, but age, gender, and heart disease risks play a part. Is it right for you?
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WebMD Feature

Sandra Rose, a nurse in Raleigh, NC, started taking a daily aspirin because "it seemed like a wonder drug," preventing heart attacks and strokes. "All the patients seemed to be on a low-dose aspirin," 63-year-old Rose says. She started taking one herself.

Then, after hearing reports of stomach bleeding caused by aspirin, this wonder drug had Rose wondering: How can you tell if a daily aspirin is right for you?

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Cardiovascular Disease and Aspirin Therapy

Heart attacks and strokes cause almost a million deaths every year in the U.S. The culprits are blood clots, which choke off the blood supply to vital organs. Aspirin works on blood cells that cause clots (platelets), making blood less likely to clot.

So if clots cause cardiovascular disease, and aspirin helps prevents clots, taking aspirin should be a no-brainer, right?

Not so fast. Aspirin's benefit comes at a cost -- an increased risk of bleeding, which usually occurs in the stomach, intestine and other gastrointestinal areas. While most of this type of bleeding is minor and stops on its own, it can be life-threatening. And there's no sure way to predict if or when it will happen.

"No medicine is innocuous," says Terry Jacobson, MD, director of the Office of Health Promotion and Disease Prevention at Emory University in Atlanta. "Anyone who's not at a high risk of heart disease has to weigh the benefits against the risks."

The right time to take aspirin is when the benefits -- reducing risk from heart attacks and strokes -- outweigh the risk of aspirin itself: dangerous stomach bleeding. This is a decision that can only be made between you and your doctor, but learning your own risk level can help you feel good about your choice.

Your Heart Disease Risk and Aspirin Therapy

There's little question aspirin has earned its reputation as a powerful drug. Studies comparing aspirin with placebo including almost 100,000 apparently healthy men and women showed:

  • In men, daily aspirin therapy cut the risk of a first heart attack by a third.
  • In women, daily aspirin therapy reduced the rate of strokes by 17%.

Certain conditions increase the likelihood of heart attacks and strokes. If you fit in this category, there's little argument: an aspirin a day helps keep trouble away.

High Risk Men and Women Who May Want Aspirin Therapy

You're considered at high risk if you have:

  • A prior heart attack or stroke caused by a blood clot
  • Known blockages or narrowing of arteries (atherosclerosis) in the heart, neck, or legs
  • Diabetes
  • Family history of heart disease
  • Multiple risk factors, such as high blood pressure, smoking, obesity, and elevated cholesterol levels and low "good" HDL cholesterol

"For people with known heart disease, it's clear that they benefit from being on an aspirin," says Jacobson, yet "people shouldn't start taking it on their own." Talking to a doctor first is essential to make sure you're not at increased risk of bleeding.

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