Is An Aspirin Daily Helping or Potentially Hurting You?

November 10, 2021

Technically the name is acetylsalicylic acid and though it has been in use since the time of Hippocrates when the bark from the willow tree was made into a powder and used as an analgesic, we know it as aspirin. It was patented in 1899 by German manufacturer Bayer.  Aspirin is commonly considered as an easy to obtain, over-the-counter medication to reduce fever and relieve headaches. It has been touted for years as a possible means to lower the risk of heart attacks and some strokes. At first blush, aspirin looks like a quick and easy way to decrease chances of blood clots that might lead to a heart attack or stroke, but it is not that simple. While aspirin can help prevent problems for some people, it is not for everyone and it does have some side effects.

Looking at risk your factors
Before deciding on your own to add an aspirin to your daily regimen, thinking that it is just a simple little aspirin and It might help reduce your risk of heart attack or a blood clot, consult your primary care physician or cardiologist to assess the benefits versus the risks. The American College of Cardiology has an established criteria of how likely a patient is to have a cardiovascular episode in the next decade. Cardiologist, Dr. Gene Iucci, DO, FACC of Penn Cardiology-Somers Point said they consider age, gender, smoking, and cholesterol level to determine a risk score.  

While it is true that aspirin had long been recommended by physicians to be taken by patients prophylactically to reduce the risk of heart attack or blood clot, a recent, (September 2021) recommendation from the United States Preventive Services Task Force (USPST) suggested patients 60 and older who have never had a heart attack or family history of heart attacks should not add a low dose aspirin to their daily medications.  Dr. Iucci said his office is fielding many calls from patients who have taken aspirin for years and are confused whether they should or should not currently be taking an aspirin daily.

“The American College of Cardiology has been talking about this since 2019,” said Dr. Iucci. “The confusion on whether or not to take a low dose aspirin daily is an individual decision between the physician and the patient, it is important to always follow the guidelines. It is also very important to remember that heart disease remains the number one cause of death. It is very important to see your provider and do not ignore symptoms.”

How aspirin works
Aspirin is the most widely used medicine in the world. Dr. Iucci explained how aspirin works. “Aspirin is a platelet inhibitor. There are platelets in our blood and they will stick to areas where there has been an injury, like a heart attack. When they are stuck together, those platelets can form a blockage,” said Dr. Iucci.  “Aspirin is a blood thinner and although it can have the benefit of stopping arterial blockage, it can also cause bleeding.”

According to Dr. Iucci, “We no longer recommend routine aspirin therapy for prevention of heart attack in patients with no previous history of stroke or coronary artery disease given its risk for bleeding. Over the age of 60, we have found there is a higher risk of bleeding due to aging tissue, GI bleeds and underlying disease. So if the patient has no history of heart disease then there is no need for aspirin.  But if there is heart disease, a high risk for a myocardial infarction, the patient has a history of stents or is at risk of a stroke or previously had a stroke, then there is a role for aspirin.”

For the 40-59 year-old group Dr. Iucci said that depends on the individual patient whether there is a benefit to taking aspirin. Together, and with the advice of their physician, they make the determination if a patient is at risk and if aspirin will benefit the patient.

Risk factor modification
“The single most important thing a person can do for themselves is risk factor modification,” said Dr. Iucci. “Make sure your cholesterol is well controlled, your blood sugar is controlled, you are not smoking, and you are getting exercise and watching your diet. If you are doing all of these, then it is a huge benefit to your health.”

To make an appointment with Dr. Gene Iucci at Penn Cardiology-Somers Point, 155 Medical Center Way in Somers Point, NJ, call 609-365-3100 or visit www.pennmedicine.org.