The Use of Aspirin for Heart Disease or Stroke Prevention

According to statistics provided by The Heart Foundation,

  • Heart disease is the number one cause of death for both men and women in the United States, claiming approximately 1 million lives annually.
  • An estimated 80 million Americans have one or more types of heart disease.

Many people who do not suffer from cardiovascular disease consider taking aspirin as secondary preventive measure. Aspirin produces statistically-significant and important reductions in cardiovascular events in survivors of a wide range of cardiovascular disease events, including coronary heart disease (CHD). The Food and Drug Administration has reviewed the available data and does not believe in the general use of aspirin for primary prevention of a heart attack or stroke.  In fact, there are serious risks associated with the use of aspirin, including increased risk of bleeding in the stomach and brain. Its net benefit (reduction in cardiovascular events versus an increase in major bleeding events) warrants the use of aspirin as a secondary prevention measure.

Platelets are particles (actually, remnants of cells) circulating in the blood that are needed in order for blood clots to form. Platelets initiate the formation of blood clots by sticking together by a process called platelet aggregation. Clumps of platelets then are further bound together by a protein (fibrin) formed by clotting factors present in the blood. The clumps of platelets and fibrin make up the blood clot.

However, if a blood clot forms inside an artery, it blocks the flow of blood to the tissue that the artery supplies, which can damage the tissue. For example, a blood clot that forms in a coronary artery supplying blood to the muscle of the heart causes a heart attack, and a blood clot that forms in an artery supplying blood to the brain causes a stroke.

What effect does Aspirin have on the heart?

Aspirin benefits the heart in the following ways:

Reduces Inflammation

Inflammation of plaque build-up or inflamed plaque is a mostly likely factor causing a heart attack or stroke. Aspirin fights the inflammation caused by a heart disease by blocking the action of an enzyme called cyclooxygenase. The blocking of this enzyme, leads to lesser production of prostaglandins which are the chemicals responsible for inflammation thereby clogging the arteries and increasing the risk of heart attack and stroke.

Stops blood clot formation

Prostaglandins may cause the blood platelets to clump together and form blood clots. The use of aspirin inhibits the formation of blood clots. Blood clots can clog the arteries and increase the incidence of heart attacks and stroke.

Lowers the risk of death

Research has shown aspirin use in lowering death in cases of cancers in colon, stomach and esophagus. It also reduces the risk of death particularly in the senior population who suffer from heart diseases and are unfit.

Reduces heart damage

The use of aspirin immediately at the onset of symptoms of a heart attack due to its anti-platelet action can significantly reduce heart damage. It can also prevent occurrence of future heart problems.

Aspirin therapy benefits the following:

  • People with coronary artery disease
  • People who have undergone a bypass surgery
  • People who have had a heart attack
  • People who have had an angioplasty/stent placement from treatment of a heart condition
  • People who have had a transient ischemic attack (TIA) or ischemic attack also referred to as “mini stroke”

If one experiences symptoms of a heart attack, you should call 911 without any delay. Aspirin is easy to use, safe at the low doses used for its anti-platelet action, and fast acting. Aspirin at moderate doses (160-325 mg/day) produces an anti-platelet effect rapidly (within 30 minutes). The current recommendation is to give aspirin immediately to almost all patients as soon as a heart attack is recognized at a dose of 160-325 mg/d and to continue it for one month. The only reason for not using aspirin is a history of intolerance or allergy to aspirin or evidence of obvious active bleeding (such as actively bleeding stomach ulcers).

Some risks associated with the use of aspirin:

Want more information, please see our additional posts as part of our month-long series dedicated to information regarding Strokes, diagnoses, treatment, prevention and care.