It’s not news that an aspirin can help save your life during a heart attack. But should we take it every day to prevent heart disease? And what kind? How much?
We met with Ashesh Parikh, DO, to clear up some of the confusion surrounding aspirin and heart health. Dr. Parikh practices at cardiology at Medical Center Alliance and Plaza Medical Center of Fort Worth, both part of HCA North Texas.
Can a daily low-dose aspirin regimen help prevent heart attacks/heart disease?
Dr. Parikh: Yes, if you’re a male over the age of 45 or a female over the age of 55, and have certain risk factors for heart disease, you should take a low-dose aspirin once a day. What some people don’t realize is that diabetes is considered a coronary artery disease equivalent, so if you have diabetes and you’re a 46-year old male, hands down you should also take low-dose aspirin every day to prevent heart attack, even if you have no other risk factors. A 50-year-old man with diabetes and a 50-year-old man who’s had one heart attack and a stent have the same risk for future heart disease.
Is taking an aspirin still recommended for a person experiencing the symptoms of a heart attack?
Dr. Parikh: Yes. If you think you’re having a heart attack, the guideline recommendations are to chew one whole aspirin (325 mg). This allows the aspirin to get absorbed into your system much faster than if you simply swallow it.
How does aspirin help during a heart attack?
Dr. Parikh: Aspirin plays a pivotal role in getting your blood thinned quickly. A heart attack is essentially a big plaque rupture, meaning you had a tear in the artery of the heart and it opened, causing a blockage. You need to get your blood as thin as possible as quickly as possible, so you can continue to get that blood flow to the heart.
Do recommendations for an aspirin regimen differ for men and women? How?
Dr. Parikh: For heart attacks, there’s primary prevention and secondary prevention. Primary prevention is preventing a heart attack or stroke from happening; secondary prevention is when you’ve already had a stroke or heart attack. In either case, the aspirin dose is the same for men and women: 81 mg once a day.
What’s the difference between low-dose aspirin, baby aspirin and regular aspirin in terms of heart health?
Dr. Parikh: Low-dose aspirin and baby aspirin are the same. That’s 81 mg a day. A full-dose aspirin is 325 mg, which is only recommended during an active heart attack. Beyond that, there’s no current daily guideline recommendation for a full-dose aspirin for anybody.
Can aspirin prevent heart attacks in everyone, or just those who have previously had a heart attack or coronary artery disease?
Dr. Parikh: Aspirin has been proven to prevent and reduce the risk of a heart attack in men over 45 or women over 55 with risk factors for heart disease. If you’ve already had a heart attack, you should take low-dose aspirin every day to help prevent future heart attacks.
Should people in overall good health take a daily aspirin to prevent heart attacks/heart disease/CAD?
Dr. Parikh: There’s no reason for [healthy women under 55 or healthy men under 45 with no risk factors for heart disease] to be on a daily aspirin. But sometimes, for example, we’ll see a woman in her 30s who’s diabetic, morbidly obese or snores, which are big risk factors for a heart attack. However, the guidelines don’t recommend aspirin for women until they’re 55. So there’s a grey zone in terms of what to do in that situation, and it’s up to the cardiologist to decide what is best for the patient.