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Your Healthy Family: Daily aspirin for heart disease prevention NOT recommended for most

Posted at 8:03 AM, Feb 12, 2019
and last updated 2019-02-12 10:03:03-05

CLEVELAND, OHIO – Many people believe the old adage that taking an aspirin every day is a harmless way to prevent heart disease – but that’s actually not the best approach for most of us.

Steve Nissen, M.D., chairman of Cardiovascular Medicine at Cleveland Clinic said there’s a growing body of research that shows the harms of taking a daily aspirin often outweigh the benefits for people who don’t already have heart disease.

“There are lots of people out there that we call the ‘worried well’ that are taking an aspirin every day to try and prevent heart disease and we don’t think that’s a wise strategy,” said Dr. Nissen. “There’s still a little bit of controversy but there’s been a crescendo of evidence to suggest that for most people an aspirin a day is not the right thing to do.”

Dr. Nissen said the concern lies in the bleeding risk that comes with taking a daily aspirin.

Aspirin reduces the blood’s ability to clot which is protective for people who have already had a heart attack, stroke or heart procedure, but for people who don’t have heart disease, aspirin increases the risk of bleeding.

Aspirin is also known to irritate the stomach and, when coupled with its anti-clotting properties, can cause bleeding in the stomach – which can be very serious, or even deadly.

Dr. Nissen said thanks to better medications, blood pressure control, and statins to lower cholesterol fewer people are considered high risk enough to recommend a daily aspirin.

“By and large our guidelines have now moved away from recommending aspirin for most people,” said Dr. Nissen. “I would estimate that many more people taking aspirin are taking it inappropriately than people who are taking it for good reasons.”

Dr. Nissen recommends talking to a health care provider if there is any uncertainty about heart disease risk.

He said people at extremely high risk for heart disease should ask their doctor if aspirin is a good option.