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Aspirin: Should I Take Daily Aspirin to Prevent a Heart Attack or Stroke?
You may want to have a say in this decision, or you may simply want to follow your doctor's recommendation. Either way, this information will help you understand what your choices are so that you can talk to your doctor about them.
Aspirin: Should I Take Daily Aspirin to Prevent a Heart Attack or Stroke?
Get the facts
Your options
- Take daily aspirin.
- Don't take daily aspirin. Instead, try to reduce your risk for a heart attack or a stroke with a healthy lifestyle.
If you have already had a heart attack or a stroke, this information does not apply to you. This decision aid is for people who have not had a heart attack or a stroke.
Key points to remember
- Aspirin may reduce your chance of having a heart attack or a stroke if you have certain risk factors, such as diabetes, high blood pressure, high cholesterol, or smoking. If you have a higher risk for a heart attack or stroke, aspirin will have even more benefit for you.
- If you have a low risk of a heart attack or stroke, the benefits of daily aspirin therapy might not outweigh the risk of bleeding problems.
- Aspirin is usually very safe. But there is an increased chance of bleeding when you take it every day.
- Even if you take aspirin every day, you still need to follow a healthy lifestyle to reduce your chance of having a heart attack or a stroke. Eat healthy foods, get regular exercise, keep your blood pressure and cholesterol levels under control, and don't smoke.
- Some people who have certain health problems shouldn't take daily aspirin. These include people who are allergic to aspirin, who have a stomach ulcer, or who recently had a stroke caused by bleeding in the brain.
How can aspirin prevent a heart attack or a stroke?
Aspirin can prevent blood clots from forming in your arteries.
People who have heart disease—or who have risk factors for heart disease—are at risk for a heart attack or a stroke. A fatty substance called plaque builds up in their arteries and narrows them. Sometimes a piece of plaque breaks open and causes a clot to form. If the clot blocks blood flow to your artery, it can cause you to have a heart attack or a stroke.
A blood clot in an artery in your heart can cause a heart attack. A clot in an artery in your brain or neck can cause a stroke.
What are the risk factors for heart attack or stroke?
You may have a higher risk of having a heart attack or a stroke if:
- You have high blood pressure.
- You have high cholesterol.
- You have low levels of HDL cholesterol, or the "good" cholesterol. HDL helps prevent cholesterol from building up in your arteries.
- You have diabetes and are at risk of heart disease.
- You have a family history of early heart disease.
- You smoke.
Your age can also increase your chance of having a heart attack or a stroke. Men older than 45 and women older than 55 have a higher risk.
Doctors use different guidelines to decide who should take daily aspirin. But no matter which guideline your doctor follows, he or she will look at your health and at your risk for a heart attack or stroke. Then you and your doctor will balance the benefits and the risks of taking a daily aspirin to see if a daily aspirin is right for you.
Who shouldn't take daily aspirin?
People who have certain health problems shouldn't take aspirin. These include people who:
- Have a stomach ulcer.
- Have recently had a stroke caused by bleeding in the brain.
- Are allergic to aspirin.
- Have high blood pressure that isn't under control.
- Have asthma that is made worse by aspirin.
Gout can become worse or hard to treat for some people who take low-dose aspirin.
If you can't take aspirin, your doctor may have you take clopidogrel (Plavix) to help prevent a heart attack or a stroke.
What are the benefits of taking daily aspirin?
Aspirin might lower your chance of having a heart attack. It also might lower the chance of a stroke or a "mini-stroke." A mini-stroke is also called a TIA.
People who have a higher risk of a heart attack or stroke may get more benefit from daily aspirin than those who have a lower risk.
If you have a low risk of a heart attack or stroke, the benefits of daily aspirin therapy might not outweigh the risk of bleeding problems.
If you have a higher risk of a heart attack or stroke, it is more likely that the benefits of aspirin outweigh the risks.
The benefits of aspirin may be different for men than they are for women. For men, aspirin seems to work better to prevent a heart attack. And for women, aspirin seems to work better to prevent a stroke.1
What are the risks of taking daily aspirin?
Aspirin is usually very safe. But there is a higher chance of bleeding when you take it every day. You'll have to weigh this risk against the benefits of taking aspirin to prevent a heart attack or a stroke.
Aspirin can also cause your stomach or another part of your digestive tract to bleed. Bleeding that is bad enough to need treatment in a hospital happens in 1 or 2 out of 1,000 people who take aspirin.2 This means that 998 or 999 out of 1,000 people who take aspirin don't have serious bleeding.
A stroke caused by bleeding in the brain is the most serious side effect of aspirin. But this is very rare.
How do you take aspirin?
Even though most people will take aspirin every day to help prevent a heart attack or a stroke, others may be advised to take aspirin every other day.
The dose for daily aspirin ranges from 75 mg to 325 mg. One adult-strength aspirin contains about 325 mg. One low-dose aspirin contains 81 mg. Low-dose aspirin is the most common dose used to prevent a heart attack or a stroke.
Even if you take aspirin every day, you still need to follow a healthy lifestyle. Here are some steps you can take to reduce your chance of having a heart attack or a stroke:
- Eat healthy foods.
- Get regular exercise.
- Keep your blood pressure and cholesterol levels under control.
- Don't smoke.
Why might your doctor recommend daily aspirin?
Your doctor may advise you to take daily aspirin if the benefits of aspirin outweigh the risk of bleeding. You might benefit from aspirin if:
- Your chance of having a heart attack or a stroke is higher than average.
- You have one or more risk factors for heart disease or stroke, such as diabetes, high blood pressure, high cholesterol, smoking, or a family history of early heart disease or stroke.
Compare your options
Compare
What is usually involved? |
| |
What are the benefits? |
| |
What are the risks and side effects? |
|
- You take aspirin every day or every other day, as your doctor recommends.
- You take steps to
reduce your chance of having a heart attack or a stroke by:
- Eating healthy foods.
- Getting regular exercise.
- Keeping your blood pressure and cholesterol levels under control.
- Not smoking.
- A daily aspirin might lower your chance of having a heart attack or a stroke.
- Possible side
effects include:
- Bleeding in your stomach and brain.
- An allergic reaction.
- You take steps to
reduce your chance of having a heart attack or a stroke by:
- Eating healthy foods.
- Getting regular exercise.
- Keeping your blood pressure and cholesterol levels under control.
- Not smoking.
- You avoid the side effects of aspirin.
- You avoid the cost of taking aspirin every day.
- Your chance of having a heart attack or a stroke may be higher.
Personal stories
Are you interested in what others decided to do? Many people have faced this decision. These personal stories may help you decide.
Personal stories about taking daily aspirin to prevent a heart attack or a stroke
These stories are based on information gathered from health professionals and consumers. They may be helpful as you make important health decisions.
I've got high blood pressure. And my father died of a heart attack. So my doctor said it would be a good idea if I took an aspirin every day. It's no big deal. I take it at night when I go to bed.
Paul, age 63
I read about aspirin and how it can prevent a heart attack or stroke, so I talked with my doctor about it. She said I don't need to take it. She told me that my risk of having a heart attack or stroke was really low. My blood pressure and cholesterol are all good, and I have a pretty healthy lifestyle. But we'll keep an eye on everything, and if it looks like my chances for a heart attack or stroke are going up, I can think about taking aspirin then.
Yvonne, age 52
I've got diabetes. So my doctor said I should take an aspirin every day, because people with diabetes have a higher risk of a heart attack or a stroke. My blood sugar is under pretty good control. But I want to do everything I can to stay healthy, so I'm taking an aspirin every morning.
Graciela, age 51
I'm taking medicine for high cholesterol and high blood pressure. I've had stomach ulcers off and on over the years. So my doctor says I shouldn't take aspirin. We agreed that I should keep my weight down and keep taking my cholesterol and blood pressure medicines.
Cal, age 48
What matters most to you?
Your personal feelings are just as important as the medical facts. Think about what matters most to you in this decision, and show how you feel about the following statements.
Reasons to take daily aspirin
Reasons not to take daily aspirin
I'm willing to take pills every day to help prevent a heart attack or a stroke.
I don't like taking pills.
I think my risk of having a heart attack or a stroke is greater than the risks of taking aspirin.
I think the risks of taking aspirin are greater than my risk of having a heart attack or a stroke.
I want to do everything I can to lower my risk of having a heart attack or a stroke.
I think I'm doing enough to lower my risk of having a heart attack or a stroke.
My other important reasons:
My other important reasons:
Where are you leaning now?
Now that you've thought about the facts and your feelings, you may have a general idea of where you stand on this decision. Show which way you are leaning right now.
Taking daily aspirin
NOT taking daily aspirin
What else do you need to make your decision?
Check the facts
If I take an aspirin every day, I might be able to prevent a heart attack or a stroke.
- TrueThat's right. Aspirin may reduce your chance of having a heart attack or a stroke if you have certain risk factors, such as diabetes, high blood pressure, high cholesterol, or smoking.
- FalseSorry, that's not right. Aspirin may reduce your chance of having a heart attack or a stroke if you have certain risk factors, such as diabetes, high blood pressure, high cholesterol, or smoking.
- I'm not sureIt may help to go back and read "Get the Facts." Aspirin may reduce your chance of having a heart attack or a stroke if you have certain risk factors, such as diabetes, high blood pressure, high cholesterol, or smoking.
If I have certain health problems, I may not be able to take aspirin.
- TrueThat's right. If you are allergic to aspirin, have a stomach ulcer, or recently had a stroke caused by bleeding in the brain, you shouldn't take aspirin.
- FalseSorry, that's not right. If you are allergic to aspirin, have a stomach ulcer, or recently had a stroke caused by bleeding in the brain, you shouldn't take aspirin.
- I'm not sureIt may help to go back and read "Get the Facts." You shouldn't take aspirin if you are allergic to aspirin, have a stomach ulcer, or recently had a stroke caused by bleeding in the brain.
I don't have to worry about any side effects from taking aspirin every day.
- TrueSorry, that's not right. Aspirin is usually very safe. But there is an increased chance of bleeding when you take it every day.
- FalseThat's right. Aspirin is usually very safe. But there is an increased chance of bleeding when you take it every day.
- I'm not sureIt may help to go back and read "Get the Facts." Aspirin is usually very safe. But there is an increased chance of bleeding when you take it every day.
Decide what's next
Do you understand the options available to you?
Are you clear about which benefits and side effects matter most to you?
Do you have enough support and advice from others to make a choice?
Certainty
How sure do you feel right now about your decision?
Check what you need to do before you make this decision.
Use the following space to list questions, concerns, and next steps.
Your Summary
Here's a record of your answers. You can use it to talk with your doctor or loved ones about your decision.
Your decision
Next steps
Which way you're leaning
How sure you are
Your comments
Your knowledge of the facts
Key concepts that you understood
Key concepts that may need review
Getting ready to act
Patient choices
Credits and References
| Credits | Healthwise Staff |
|---|---|
| Primary Medical Reviewer | Rakesh K. Pai, MD, FACC - Cardiology, Electrophysiology |
| Specialist Medical Reviewer | Robert A. Kloner, MD, PhD - Cardiology |
Aspirin: Should I Take Daily Aspirin to Prevent a Heart Attack or Stroke?
- Get the facts
- Compare your options
- What matters most to you?
- Where are you leaning now?
- What else do you need to make your decision?
1. Get the facts
Your options
- Take daily aspirin.
- Don't take daily aspirin. Instead, try to reduce your risk for a heart attack or a stroke with a healthy lifestyle.
If you have already had a heart attack or a stroke, this information does not apply to you. This decision aid is for people who have not had a heart attack or a stroke.
Key points to remember
- Aspirin may reduce your chance of having a heart attack or a stroke if you have certain risk factors, such as diabetes, high blood pressure, high cholesterol, or smoking. If you have a higher risk for a heart attack or stroke, aspirin will have even more benefit for you.
- If you have a low risk of a heart attack or stroke, the benefits of daily aspirin therapy might not outweigh the risk of bleeding problems.
- Aspirin is usually very safe. But there is an increased chance of bleeding when you take it every day.
- Even if you take aspirin every day, you still need to follow a healthy lifestyle to reduce your chance of having a heart attack or a stroke. Eat healthy foods, get regular exercise, keep your blood pressure and cholesterol levels under control, and don't smoke.
- Some people who have certain health problems shouldn't take daily aspirin. These include people who are allergic to aspirin, who have a stomach ulcer, or who recently had a stroke caused by bleeding in the brain.
How can aspirin prevent a heart attack or a stroke?
Aspirin can prevent blood clots from forming in your arteries.
People who have heart disease—or who have risk factors for heart disease—are at risk for a heart attack or a stroke. A fatty substance called plaque builds up in their arteries and narrows them. Sometimes a piece of plaque breaks open and causes a clot to form. If the clot blocks blood flow to your artery, it can cause you to have a heart attack or a stroke.
A blood clot in an artery in your heart can cause a heart attack. A clot in an artery in your brain or neck can cause a stroke.
What are the risk factors for heart attack or stroke?
You may have a higher risk of having a heart attack or a stroke if:
- You have high blood pressure.
- You have high cholesterol.
- You have low levels of HDL cholesterol, or the "good" cholesterol. HDL helps prevent cholesterol from building up in your arteries.
- You have diabetes and are at risk of heart disease.
- You have a family history of early heart disease.
- You smoke.
Your age can also increase your chance of having a heart attack or a stroke. Men older than 45 and women older than 55 have a higher risk.
Doctors use different guidelines to decide who should take daily aspirin. But no matter which guideline your doctor follows, he or she will look at your health and at your risk for a heart attack or stroke. Then you and your doctor will balance the benefits and the risks of taking a daily aspirin to see if a daily aspirin is right for you.
Who shouldn't take daily aspirin?
People who have certain health problems shouldn't take aspirin. These include people who:
- Have a stomach ulcer.
- Have recently had a stroke caused by bleeding in the brain.
- Are allergic to aspirin.
- Have high blood pressure that isn't under control.
- Have asthma that is made worse by aspirin.
Gout can become worse or hard to treat for some people who take low-dose aspirin.
If you can't take aspirin, your doctor may have you take clopidogrel (Plavix) to help prevent a heart attack or a stroke.
What are the benefits of taking daily aspirin?
Aspirin might lower your chance of having a heart attack. It also might lower the chance of a stroke or a "mini-stroke." A mini-stroke is also called a TIA.
People who have a higher risk of a heart attack or stroke may get more benefit from daily aspirin than those who have a lower risk.
If you have a low risk of a heart attack or stroke, the benefits of daily aspirin therapy might not outweigh the risk of bleeding problems.
If you have a higher risk of a heart attack or stroke, it is more likely that the benefits of aspirin outweigh the risks.
The benefits of aspirin may be different for men than they are for women. For men, aspirin seems to work better to prevent a heart attack. And for women, aspirin seems to work better to prevent a stroke.1
What are the risks of taking daily aspirin?
Aspirin is usually very safe. But there is a higher chance of bleeding when you take it every day. You'll have to weigh this risk against the benefits of taking aspirin to prevent a heart attack or a stroke.
Aspirin can also cause your stomach or another part of your digestive tract to bleed. Bleeding that is bad enough to need treatment in a hospital happens in 1 or 2 out of 1,000 people who take aspirin.2 This means that 998 or 999 out of 1,000 people who take aspirin don't have serious bleeding.
A stroke caused by bleeding in the brain is the most serious side effect of aspirin. But this is very rare.
How do you take aspirin?
Even though most people will take aspirin every day to help prevent a heart attack or a stroke, others may be advised to take aspirin every other day.
The dose for daily aspirin ranges from 75 mg to 325 mg. One adult-strength aspirin contains about 325 mg. One low-dose aspirin contains 81 mg. Low-dose aspirin is the most common dose used to prevent a heart attack or a stroke.
Even if you take aspirin every day, you still need to follow a healthy lifestyle. Here are some steps you can take to reduce your chance of having a heart attack or a stroke:
- Eat healthy foods.
- Get regular exercise.
- Keep your blood pressure and cholesterol levels under control.
- Don't smoke.
Why might your doctor recommend daily aspirin?
Your doctor may advise you to take daily aspirin if the benefits of aspirin outweigh the risk of bleeding. You might benefit from aspirin if:
- Your chance of having a heart attack or a stroke is higher than average.
- You have one or more risk factors for heart disease or stroke, such as diabetes, high blood pressure, high cholesterol, smoking, or a family history of early heart disease or stroke.
2. Compare your options
| Take daily aspirin | Don't take daily aspirin | |
|---|---|---|
| What is usually involved? |
|
|
| What are the benefits? |
|
|
| What are the risks and side effects? |
|
|
Personal stories
Are you interested in what others decided to do? Many people have faced this decision. These personal stories may help you decide.
Personal stories about taking daily aspirin to prevent a heart attack or a stroke
These stories are based on information gathered from health professionals and consumers. They may be helpful as you make important health decisions.
"I've got high blood pressure. And my father died of a heart attack. So my doctor said it would be a good idea if I took an aspirin every day. It's no big deal. I take it at night when I go to bed."
— Paul, age 63
"I read about aspirin and how it can prevent a heart attack or stroke, so I talked with my doctor about it. She said I don't need to take it. She told me that my risk of having a heart attack or stroke was really low. My blood pressure and cholesterol are all good, and I have a pretty healthy lifestyle. But we'll keep an eye on everything, and if it looks like my chances for a heart attack or stroke are going up, I can think about taking aspirin then."
— Yvonne, age 52
"I've got diabetes. So my doctor said I should take an aspirin every day, because people with diabetes have a higher risk of a heart attack or a stroke. My blood sugar is under pretty good control. But I want to do everything I can to stay healthy, so I'm taking an aspirin every morning."
— Graciela, age 51
"I'm taking medicine for high cholesterol and high blood pressure. I've had stomach ulcers off and on over the years. So my doctor says I shouldn't take aspirin. We agreed that I should keep my weight down and keep taking my cholesterol and blood pressure medicines."
— Cal, age 48
3. What matters most to you?
Your personal feelings are just as important as the medical facts. Think about what matters most to you in this decision, and show how you feel about the following statements.
Reasons to take daily aspirin
Reasons not to take daily aspirin
I'm willing to take pills every day to help prevent a heart attack or a stroke.
I don't like taking pills.
I think my risk of having a heart attack or a stroke is greater than the risks of taking aspirin.
I think the risks of taking aspirin are greater than my risk of having a heart attack or a stroke.
I want to do everything I can to lower my risk of having a heart attack or a stroke.
I think I'm doing enough to lower my risk of having a heart attack or a stroke.
My other important reasons:
My other important reasons:
4. Where are you leaning now?
Now that you've thought about the facts and your feelings, you may have a general idea of where you stand on this decision. Show which way you are leaning right now.
Taking daily aspirin
NOT taking daily aspirin
5. What else do you need to make your decision?
Check the facts
1. If I take an aspirin every day, I might be able to prevent a heart attack or a stroke.
- True
- False
- I'm not sure
2. If I have certain health problems, I may not be able to take aspirin.
- True
- False
- I'm not sure
3. I don't have to worry about any side effects from taking aspirin every day.
- True
- False
- I'm not sure
Decide what's next
1. Do you understand the options available to you?
2. Are you clear about which benefits and side effects matter most to you?
3. Do you have enough support and advice from others to make a choice?
Certainty
1. How sure do you feel right now about your decision?
2. Check what you need to do before you make this decision.
- I'm ready to take action.
- I want to discuss the options with others.
- I want to learn more about my options.
3. Use the following space to list questions, concerns, and next steps.
| By | Healthwise Staff |
|---|---|
| Primary Medical Reviewer | Rakesh K. Pai, MD, FACC - Cardiology, Electrophysiology |
| Specialist Medical Reviewer | Robert A. Kloner, MD, PhD - Cardiology |
Note: The "printer friendly" document will not contain all the information available in the online document some Information (e.g. cross-references to other topics, definitions or medical illustrations) is only available in the online version.
Last Revised: May 8, 2012
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