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Straight, No Chaser: Should I Take a Daily Aspirin?

By Jeffrey Sterling, MD February 27, 2020

heart aspirin

So… I’m stuck on a desert island, and I’m allowed to take two medications. I’m pretty sure aspirin is going to be one of them. This begs the question “Who should take a daily aspirin?” The answer is actually easy: anyone and only anyone whose physician recommends it. The better question is when will your physician recommend it? In yesterday’s Straight, No Chaser, we reviewed the expanding use of aspirin. That was the “why” of it all. Today we look at the “how” and “when.”
The benefits of aspirin in reducing heart attack risk have been known and well described for quite a while now, and you should check this list to see if you’d benefit from taking a daily aspirin. Truth be told, it’s of such importance that if you’re of a certain age, you should have this conversation with your physician at your next physical exam. Here’s a partial list that will get you a daily aspirin or very strongly considered for one.

  • If you’ve previously had a heart attack
  • If you’ve had a coronary artery stent or surgery
  • If you’ve previously had a stroke (caused by a blood clot) or TIA (transient ischemia attack, aka ‘mini-stroke’).
  • You’re a male over 50.
  • You’re a female over 60.
  • You have a bad risk factor profile (i.e. You smoke, have diabetes, high blood pressure or high cholesterol levels, are overweight, don’t exercise or have a personal or family history of heart disease)

The above list actually isn’t exhaustive but is sufficient for most individuals’  ability to remember to start a conversation with their physician.  These considerations will be measured against others that would suggest you shouldn’t be taking a daily aspirin (e.g. allergy, bleeding ulcers, a bleeding disorder or if you’re taking certain other medications).
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