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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?

Your Heart Disease Risk and Aspirin Therapy continued...

Very Low-Risk Men and Women Who May Not Want Aspirin Therapy

Low-risk people include men under 40 and women under 50. While it helps to know that aspirin does reduce healthy people's risk of heart disease and stroke, their risk is low to begin with. And daily aspirin may increase their risk of internal bleeding. For example, if 1,000 healthy people took an aspirin daily for about six years:

  • Daily aspirin would prevent three or four serious cardiovascular events (heart attacks, strokes, or heart disease deaths).
  • However, aspirin would cause about three life-threatening gastrointestinal bleeds.

Unless you have risk factors for heart disease, an aspirin won't help, and may do harm. Talk to a doctor before taking daily aspirin -- because you probably shouldn't.

Low to Medium Risk: Your Choice on Aspirin Therapy

So people at high risk should take an aspirin, and people at very low risk shouldn't. What about everyone in between -- the vast majority of us?

The answer is: it depends. Jacobson suggests putting this question to your doctor: Am I at high enough cardiovascular risk to justify taking an aspirin, even with the small but real risk of significant bleeding?

"The more risk factors that you have, the greater the chance that you will benefit" from daily aspirin, Jacobson tells WebMD.

Your doctor can calculate your cardiovascular disease risks based on the following factors:

  • Your medical history
  • Age
  • Smoking
  • High blood pressure
  • Total and "good" cholesterol levels
  • History of heart disease in close relatives

If you know your blood pressure and cholesterol, you can calculate your own 10-year risk of serious cardiovascular disease using the same tool that doctors use. Called the "Framingham risk calculator," it's available online at:

If the benefits do outweigh the risks for you, how much aspirin should you take? Talk to your doctor first. The standard dose is one baby aspirin (81 milligrams) a day. Higher doses are no more effective, and can cause more stomach upset.

Aspirin: Different Benefits for Men and Women

When it comes to heart attacks and strokes, men and women are not created equal. Women develop cardiovascular disease later than men -- usually after menopause, and often well into their 70s. Their disease symptoms and survival can be very different from men.

For many women, this difference means the risk of cardiovascular disease doesn't justify aspirin until later in life. However, the risk of bleeding while on aspirin also goes up with age, making the choice more complicated.

And women are different from men when it comes to the response to aspirin as well, says Nanette Wenger, MD, spokesperson for the American Heart Association. Based on study data:

  • For healthy men aspirin seems to prevent heart attacks, but not strokes.
  • For healthy women under 65, aspirin prevents strokes, but not heart attacks.
  • For healthy women over 65, aspirin appears to prevent heart attacks similarly to men.

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