Heart Health FAQs

If you or a loved one has had a heart attack or ischemic stroke, you probably have lots of questions about aspirin and heart disease. Check out some of the most frequently asked questions below.

Aspirin for Your Heart

How does aspirin work?

Aspirin reduces the production of hormone-like substances called prostaglandins, which are produced in tissues throughout the body. Prostaglandins have many functions. They are part of the chemical messenger systems involved in feeling pain, fever, the redness and swelling that can accompany injuries, and even in contracting certain muscles like the uterus. Since aspirin lowers the amount of prostaglandins, it can help alleviate conditions like pain, fever, and the discomfort of menstrual cramps.

Aspirin also reduces production of substances involved in the early stages of our body's blood clotting mechanism. This is why doctors may prescribe an aspirin regimen for some individuals to reduce the risk of heart attack or stroke.

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Is aspirin safe?

It's important that you talk to your doctor to help you decide if an aspirin regimen is right for you.

For most people, aspirin is safe when used as directed. But for some people, aspirin can cause side effects. Some of these side effects can be serious, such as bleeding in the stomach or other bleeding. This is rare and usually related to long-term use of high-dosage aspirin beyond traditional over-the-counter use.

Long-term use of aspirin must be directed and monitored by your doctor. This includes:

Taking an aspirin regimen for recurrent heart attack or ischemic stroke prevention
Use of aspirin for longer than 10 days for pain
Use of aspirin for longer than 3 days for fever

Can aspirin therapy help prevent recurrent heart attacks or ischemic strokes?

Aspirin has been shown to reduce the risk of recurrent heart attacks or ischemic strokes (strokes caused by a blood clot). Aspirin also may save your life when taken during a suspected heart attack. Both men and women may benefit from aspirin use.

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Who should take aspirin to prevent recurrent heart attacks or ischemic strokes?

The Food and Drug Administration (FDA) has approved the use of aspirin to reduce the risk of heart attacks and strokes in men and women who have had a heart attack or ischemic stroke. Aspirin is not appropriate for everyone, so be sure to talk to your doctor before you begin an aspirin regimen.

If you have one or more of the following conditions, talk to your doctor about whether an aspirin regimen is right for you:

You have had a heart attack
You have previously had an ischemic stroke or a mini-stroke (transient ischemic attack)
You have unstable or stable angina
You have had certain heart procedures, such as angioplasty or a coronary bypass operation

People with certain conditions or taking certain medications should avoid aspirin. For more information, see Who should avoid taking aspirin? or talk to your doctor.

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What is the recommended dose for recurrent heart attack prevention?

For recurrent heart attack prevention, the FDA has approved the use of aspirin in lower dosages (between 75 and 325 mg). That's because research suggests that lower doses may reduce potential side effects but still maintain efficacy. Aspirin is not right for everyone, so be sure to talk to your doctor before you begin an aspirin regimen.

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Should healthy people take aspirin to prevent heart attacks?

No. The risks of an aspirin therapy may outweigh the benefits for apparently healthy people without any symptoms of heart disease. If you have high blood cholesterol, diabetes, a family history of heart disease, or other major risk factors for a heart attack, talk to your doctor about what you can do to reduce your risk of heart attack and heart disease.

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Should you take aspirin if you suspect you are having a heart attack?

Studies show that taking aspirin as soon as a heart attack is suspected may reduce the risk of death or complications from the heart attack. If you suspect you are having a heart attack, get emergency medical care immediately. Ask your doctor now if you should take aspirin in the event of a suspected heart attack.

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What are the possible side effects of long-term aspirin use?

Long-term aspirin use may be associated with side effects. These may include increased or prolonged bleeding, stomach or intestinal, and stomach ulcers. For most people, long-term aspirin use is safe when directed and monitored by a doctor.

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Can aspirin prevent all kinds of strokes?

It's important to know that there are two kinds of strokes. An ischemic stroke is caused by a blood clot blocking the flow of blood in part of the brain. About 4 out of 5 strokes are ischemic. A hemorrhagic stroke is caused by bleeding from a burst blood vessel in the brain or on the surface of the brain. About 1 out of 5 strokes are hemorrhagic.

An aspirin regimen may help prevent a second ischemic stroke, but will not prevent hemorrhagic strokes. In fact, aspirin use slightly increases the risk of hemorrhagic stroke. So, if you have a history of stroke, make sure you know what kind of stroke you had and talk to your doctor about whether aspirin use is right for you.

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Do other OTC drugs help treat or prevent heart attacks or strokes?

Aspirin is the only OTC drug that has been shown to prevent heart attack or ischemic stroke. Like aspirin, acetaminophen (for example, Tylenol®), ibuprofen (Advil®, Motrin®), and naproxen sodium (Aleve®) are drugs that treat pain and fever. However, only aspirin has demonstrated a beneficial effect for recurrent heart attack and stroke prevention.

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Who should avoid taking aspirin?

If you talk with your doctor about an aspirin regimen, ask if there is any reason not to take aspirin. Some people have conditions that aspirin may make worse. In general, your doctor will look at whether you have:

An allergy to aspirin or other salicylates
Asthma
Stomach ulcers or a history of ulcers
Inherited bleeding disorders (hemophilia) or acquired bleeding disorders (liver disease or vitamin K deficiency)
A history of hemorrhagic stroke (a stroke caused by bleeding in the brain)
Reduced liver or kidney function
Uncontrolled high blood pressure

Tell your doctor if you have three or more alcoholic drinks every day.

It's important to talk to your doctor about all of your prescription and nonprescription (OTC) medications before you begin an aspirin regimen because aspirin can interact with other drugs you may be taking. For example, if you are taking a blood thinning medicine, such as heparin or warfarin, aspirin use can increase your risk of bleeding.

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If I am on an aspirin regimen, can I take aspirin for pain?

Yes. For people on an aspirin regimen, additional aspirin can be taken for occasional pain like headaches, muscle aches, fever, or minor arthritis pain. As with any aspirin product, the total maximum daily dose should not exceed 4,000 mg. Each dose for pain should still be taken according to the label directions.

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Cardiovascular Disease and Heart Attacks

What should I know about cardiovascular disease?

An estimated 81 million American adults (one in three) have one or more types of cardiovascular disease. This includes high blood pressure (HBP), heart failure, stroke, and stable or unstable angina. Of the 81 million people, approximately 8.5 million suffer a heart attack and 6.4 million suffer from stroke over time.

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What are the risk factors for heart disease?

Some risk factors for heart disease can be modified, including:

Obesity
Tobacco Smoke
Physical Inactivity
High Cholesterol
High Blood Pressure

Factors that can't be modified are gender, age, and if you have diabetes or a family history of heart disease.

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How can I reduce my risk of cardiovascular disease?

You can reduce your risk of recurrent heart attack and ischemic stroke with a healthier lifestyle. Ask your doctor what you can do to reduce high blood pressure and high blood cholesterol. Your doctor can also tell you about the benefits of quitting smoking, losing weight, and exercising.

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What should I know about diabetes in relation to cardiovascular disease?

Diabetes increases your risk of atherosclerosis, a mechanism that narrows the blood vessels and clogs the arteries, and increases your risk of heart attack or ischemic stroke.

Adults with diabetes have heart disease death rates about 2 to 4 times higher than adults without diabetes. The risk for stroke is 2 to 4 times higher among people with diabetes.

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What should I do if I suspect a heart attack?

If you suspect you are having a heart attack, call 911 immediately and take aspirin as directed by a doctor. Studies show that taking aspirin as soon as a heart attack is suspected reduces the risk of death or complications from the heart attack. Ask your doctor now if you should take aspirin if you think you are having a heart attack.

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What is a heart attack?

During a heart attack, one or more of the arteries supplying blood to the heart muscle is blocked. This blockage severely reduces or stops blood supply to part of the heart. If the blood supply is cut off for a long time, these heart muscle cells could become irreversibly damaged. Depending on the level of damage, disability or death can result.

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