Aspirin prevents blood clots from forming in the arteries. Doctors sometimes recommend daily aspirin for people at high risk of heart attack or stroke.
But taking aspirin isn't right for everyone, because it can cause serious bleeding. You and your doctor can decide if aspirin is a good choice for you.
For people who have had a heart attack: Aspirin can help prevent a second heart attack. Your doctor has probably already prescribed aspirin for you.
For people who have had a stroke: Aspirin can help prevent a second stroke or a transient ischemic attack (TIA), which is often a warning sign of a stroke.
For people who have never had a heart attack or stroke: Talk to your doctor before you start taking aspirin every day. Aspirin lowers the risk of heart attack and stroke. But aspirin can also cause serious bleeding. You and your doctor can decide if aspirin is a good choice for you based on your risk of a heart attack and stroke and your risk of serious bleeding.
Aspirin may also be used by people who:
Experts recommend that most people who have never had a heart attack or stroke should not take aspirin. That's because for people who aren't at high risk of heart problems, the chance of bleeding from taking aspirin tends to outweigh the benefits.
Also, people who have certain health problems shouldn't take aspirin. These include people who:
If aspirin upsets your stomach, you can try taking it with food. But if that doesn't help, talk with your doctor. Aspirin can irritate the stomach lining and sometimes cause serious problems.
Before you have a surgery or procedure that may cause bleeding, tell your doctor or dentist that you take aspirin. Aspirin may cause you to bleed more than usual. He or she will tell you if you should stop taking aspirin before your surgery or procedure. Make sure that you understand exactly what your doctor wants you to do.
Do not suddenly stop taking aspirin without talking to your doctor first. Talking to your cardiologist first is especially important if you have had a stent placed in a coronary artery.
Call your doctor now or seek immediate medical care if you have any abnormal bleeding, such as:
Aspirin should not be taken with many prescription and over-the-counter drugs, vitamins, herbal remedies, and supplements. So before you start aspirin therapy, talk to your doctor about all the drugs and other remedies you take.
Although nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen and naproxen relieve pain and inflammation much like aspirin does, they do not affect blood clotting in the same way that aspirin does. Do not substitute NSAIDs for aspirin. NSAIDs may increase your risk for a heart attack or stroke.
If you need both aspirin and an NSAID pain reliever every day, talk to your doctor first. Ask your doctor what pain reliever you should take. You may be able to use another type of pain reliever, such as acetaminophen, to treat your pain.
If you take an NSAID every day, your doctor may recommend that you take the NSAID and aspirin pills at different times. If you take these pills at the same time, aspirin might not work as well to prevent a heart attack or stroke. Do not take the NSAID pill during either the 8 hours before or the 30 minutes after you take aspirin. Here's an example: Take your aspirin. Wait 30 minutes. Then take your NSAID.
If you take an NSAID once in a while, it does not seem to cause problems with aspirin.
Ask your doctor if you can drink alcohol while you take aspirin. And ask how much you can drink. Too much alcohol with aspirin can cause stomach bleeding.
If you are pregnant, do not take aspirin unless your doctor says it is okay.
Talk to your doctor before taking daily aspirin. It's not right for everyone.
If you and your doctor decide that daily aspirin is right for you, your doctor will recommend a dose of aspirin and how often to take it. Low-dose aspirin (81 mg) is the most common dose used to prevent a heart attack or a stroke. A typical schedule is to take aspirin every day. Be sure you know what dose of aspirin to take and how often to take it.
Aspirin can cause serious bleeding. Be sure you get instructions about how to take aspirin safely.
Aspirin slows the blood's clotting action by reducing the clumping of platelets. Platelets are cells that clump together and help to form blood clots. Aspirin keeps platelets from clumping together, thus helping to prevent or reduce blood clots.
Most heart attacks and strokes are caused by blood clots. Blood clots can form in arteries and block the flow of oxygen-rich blood to the heart muscle or part of the brain.
When taken daily after having a heart attack or stroke, aspirin helps prevent dangerous clots from happening again.
Daily aspirin may also be helpful for preventing clots in some people who are at high risk for a heart attack or stroke if they are also at low risk of bleeding problems, which can happen more while taking aspirin because it reduces clots. That's why it's important to talk to your doctor before starting daily aspirin.
Citations
- Arnett DK, et al. (2019). 2019 ACC/AHA guideline on the primary prevention of cardiovascular disease. Circulation, published online March 17, 2019: CIR0000000000000678. DOI: 10.1161/CIR.0000000000000678. Accessed March 26, 2019. [Erratum in Circulation, 140(11): e649–e650. DOI: 10.1161/CIR.0000000000000725. Accessed September 10, 2019.]
- Zheng SL, Roddick AJ (2019). Association of aspirin use for primary prevention with cardiovascular events and bleeding events: A systematic review and meta-analysis. JAMA, 321(3): 277–287. DOI: 10.1001/jama.2018.20578. Accessed April 30, 2019.
Current as of: January 10, 2022
Author: Healthwise Staff
Medical Review:Rakesh K. Pai MD, FACC - Cardiology, Electrophysiology & E. Gregory Thompson MD - Internal Medicine & Martin J. Gabica MD - Family Medicine & Elizabeth T. Russo MD - Internal Medicine & Adam Husney MD - Family Medicine & Robert A. Kloner MD, PhD - Cardiology
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