Aspirin and your heart

If you have a headache, toothache or other everyday pain, aspirin can be a good, occasional friend. If you've had a heart attack or a common type of stroke, aspirin may become a trusted, constant companion—maybe even a lifesaver.

That's because aspirin can do more than control minor aches and pains. Taken correctly, it may also protect the heart and blood vessels.

Who aspirin can help

Researchers have found that aspirin helps prevent a second heart attack, a second stroke and serious recurrent angina, according to the American Heart Association (AHA). As a result, people with a history of these conditions may be advised to take aspirin regularly.

According to the U.S. Food and Drug Administration (FDA), aspirin can also be used after coronary bypass surgery or angioplasty to help prevent complications.

"If you've had a stroke caused by a blood clot, a heart attack, bypass surgery—anything involving coronary arteries, you need to take a [low-dose] aspirin," says Gerald Fletcher, MD, an AHA volunteer expert.

However, while the science is clear about the value of aspirin in preventing second heart attacks and strokes, more research needs to be done on aspirin's role for people who haven't had a cardiovascular event.

Still, some studies also indicate that aspirin may help people at high risk avoid their first stroke or heart attack. This may include people with high cholesterol, high blood pressure, or a family history of heart attack or stroke, Dr. Fletcher says.

How aspirin works

Aspirin is an antiplatelet drug, meaning it works on platelets, disk-shaped cells in the blood that clump together to help form blood clots.

Blood clots, of course, are essential to repairing cuts. But clots can also cause problems.

For example, when blood vessels are damaged by smoking, cholesterol or high blood pressure, a substance called plaque can build up. When plaque breaks free, platelets respond. That can lead to the formation of a blood clot inside the vessel.

A clot can prevent blood from flowing to the heart muscle, causing a heart attack. If a clot blocks blood flow to the brain, it causes a stroke.

But an antiplatelet drug such as aspirin can help keep blood vessels clear by limiting platelets’ clumping ability.

The right dose

When aspirin is taken to prevent blood vessel problems, the dosage is usually 81 milligrams a day. By comparison, pills for occasional pain relief contain 325 milligrams of aspirin.

"Eighty-one milligrams will usually do it," Dr. Fletcher says. "Some people think twice that dosage is better, but it's fairly routine to take a [low-dose] aspirin."

Such a small dose of such a common medicine may lead some people to think they can start taking daily low-dose aspirin on their own. But experts say otherwise.

It's important to talk to your doctor first, Dr. Fletcher says, because even well-known medications like aspirin can cause problems for some people.

According to the FDA, the same antiplatelet properties that help aspirin prevent heart attacks and strokes can also lead to unwanted side effects such as stomach bleeding, kidney failure and bleeding in the brain.

In addition, aspirin may cause problems when taken with other medications, including blood thinners.

Before taking a daily aspirin, tell your doctor about all the prescription and over-the-counter medications and supplements you're taking.

Despite its potential risks, aspirin is an important treatment for many people, especially those hoping to prevent a second cardiovascular event.

"This is a very simple medication, available over the counter and with very few side effects," Dr. Fletcher says.

Just check with your doctor before using it, he says.

reviewed 12/4/2018

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