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Total Health

Daily Aspirin Therapy

Also called: Aspirin Therapy

Reviewed By:
David Slotnick, M.D.

Summary

At their physician’s direction, millions of people take a daily aspirin to prevent heart attack and stroke and help improve blood flow to the heart. Evidence of a daily aspirin’s cardiovascular benefits has been building since research began on the topic in the early 1970s.

Over the years, additional research not only confirmed the benefit of a daily aspirin, but also illuminated other benefits. Research has concluded that aspirin may help prevent a first and second heart attack or stroke. In addition, continuing research has found that aspirin can reduce the risk of certain types of cancer, such as ovarian, colon, pancreatic and esophageal cancers.

Starting a daily aspirin regimen should only be considered after consultation with a physician. Aspirin, like any medication, can cause several side effects and may affect people in different ways, depending on the dosage.

About taking a daily aspirin

At their physician’s direction, millions of people take a daily aspirin to prevent heart attack and stroke and to help improve blood flow to the heart. Evidence of a daily aspirin’s cardiovascular benefits has been building since research began on the topic in the early 1970s.

Over the years, additional research not only confirmed the benefit of a daily aspirin, but also illuminated other benefits. Research has concluded that aspirin may help prevent a first and second heart attack or stroke. In addition, continuing research has found that aspirin can reduce the risk of certain types of cancer, such as ovarian, colon, pancreatic and esophageal cancers. However, daily aspirin therapy is currently not advised to prevent cancer.

In 1988, the Physicians' Health Study, led by Dr. Charles H. Hennekens, was launched to demonstrate the benefits of a daily aspirin. This now-famous study involved physicians who took a daily aspirin without knowing the ingredients. One half of the participants took aspirin and the other half took a sugar pill. The study found that a daily aspirin reduced the risk of a first heart attack by 44 percent. Follow-up studies have confirmed the benefits of a daily aspirin.

In light of these promising findings for heart patients, the American Heart Association (AHA) currently recommends that patients who have experienced a heart attack, unstable angina, ischemic stroke, or transient ischemic attack (TIAs or ‘mini strokes’) should consult their physician about starting daily aspirin therapy.

In addition, daily aspirin may be recommended for patients who have undergone coronary artery bypass surgery. In these cases, aspirin has been shown to reduce the chance of death by vascular disease.

Non-prescription aspirin used for its heart protective benefits is usually taken once a day. Some studies have suggested that 81 mg (the amount contained in one baby aspirin) offers sufficient heart-protective properties while more recent studies recommend 325 mg (a single adult aspirin). Studies have shown that the benefits are limited below 70 mg a day.

All patients should consult their physician before deciding to take an aspirin every day. Some patients may be allergic to aspirin or have conditions that contraindicate aspirin therapy, such as ulcers, history of gastrointestinal bleeding or a general tendency to bleed. A physician may recommend that patients take an enteric-coated aspirin to reduce these risks. However, coated aspirin reduces the effective dose available to the body.

Furthermore, people taking an anticoagulant such as warfarin should not take aspirin (daily or otherwise) unless advised by their physician. This is because both medications increase the risk of bleeding. People taking nonsteroidal anti-inflammatory drugs (NSAIDs) may also be discouraged from taking aspirin.

If your physician is considering your taking both a daily aspirin and NSAID, the NSAID must be taken more than two hours after the aspirin in order to prevent rendering the aspirin ineffective. Finally, people should not take aspirin if they are pregnant, hypertensive, allergic to certain medications or about to go in for surgery, unless specifically recommended to do so by their physician.

Questions for your doctor

Preparing questions in advance can help patients to have more meaningful discussions with their physicians regarding their conditions. Patients may wish to ask their doctor the following questions related to taking a daily aspirin:

  1. Should I take an aspirin daily?

  2. What dosage would be best for me?

  3. Does it matter what time of day I take the aspirin? Should I take it with food?

  4. Will it affect any other medications I'm taking?

  5. If I experience stomachaches, can I reduce the dosage?

  6. Is there any other medication that might accomplish the same thing with fewer side effects?

  7. Are there any risks to taking a daily aspirin?

  8. Does the brand of aspirin matter? Should I take enteric coated or regular aspirin?

  9. If I miss a day or two, am I at higher risk for a heart attack?

  10. What dosage of aspirin should I chew if I think I'm having a heart attack?
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