Does a daily aspirin help prevent a heart attack? That depends. If you currently have no heart disease risk factors, a new study says you may want to think twice before taking aspirin.
For years, millions of people have been taking a daily low-dose aspirin in the hope of preventing a heart attack or stroke. Now, research from Italy indicates the risks of bleeding from aspirin may outweigh its heart-protective benefits in healthy people.
Risk of Bleeding
The Italian study found 186,000 patients taking daily doses of aspirin up to 300 milligrams, have a 55 percent increased risk of gastrointestinal bleeding and a 54 percent increased risk of brain bleeding.
Although the researchers were looking for differences in how aspirin affects patients with diabetes and those without, their findings are noteworthy for millions of people using aspirin to prevent heart problems.
When Aspirin is Helpful
If you already had a heart attack or stroke, there is substantial evidence to recommend taking aspirin to prevent another heart attack—or even death.
A review of the data for 135,640 patients who had a first heart attack or stroke showed an 18 to 30 percent reduction in risk of a second event with aspirin doses of 75 to 150 milligrams daily.
The data in favor of aspirin use is less clear before a heart attack or stroke has occurred, although several groups, including the U.S. Preventive Services Task Force, the American College of Cardiology, American Heart Association, and the American Diabetes Association, believe that some people may benefit.
If you’re at high risk for developing heart disease and low risk for gastrointestinal or brain bleeding, it’s recommended you take a low-dose (baby) aspirin to prevent a heart attack or stroke.
Data indicate a 32 percent risk reduction in men 45 to 79 years of age, particularly if they have two or more of these risk factors: age, history of diabetes, elevated cholesterol, cigarette use, a strong family history of heart disease, and high blood pressure. In women 55 to 79 years of age, there was a 17 percent reduction in risk of stroke, but not heart attacks.
What Should You Do?
It’s well-known that higher doses of aspirin may lead to an increased risk of bleeding. So, it’s important to point out that the aspirin dose taken in the Italian study was higher than what we prescribe in daily practice, and may partly account for the increased risk of bleeding.
Before starting an aspirin regimen, talk to your healthcare provider so he or she can assess your risks.
The Impact of a Healthy Lifestyle
And don’t forget the impact lifestyle changes can make on your heart-disease risk without aspirin. You can lower your risk of heart disease by 10 percent to 30 percent if you exercise, lower your cholesterol, eat a low-fat, low-carbohydrate diet, stop smoking if you do, and maintain a healthy weight.