Sunday, April 25, 2010

Daily aspirin therapy: Understand the benefits and risks

Is an aspirin a day the right thing for you?

It's not as easy a decision as it sounds. Know the benefits and risks before considering daily aspirin therapy. By Mayo Clinic staff

Daily aspirin therapy may lower your risk of heart attack and stroke, but daily aspirin therapy isn't for everyone. Is it right for you?

You should consider daily aspirin therapy only if you've had a heart attack or stroke, or you have a high risk of either. And then, only take aspirin with your doctor's approval. Although taking an occasional aspirin or two is safe for most adults to use for headaches, body aches or fever, daily use of aspirin can have serious side effects, including internal bleeding.

How does aspirin prevent a heart attack or stroke?
Aspirin interferes with your blood's clotting action. When you bleed, your blood's clotting cells, called platelets, build up at the site of your wound. The platelets help form a plug that seals the opening in your blood vessel to stop bleeding.

But this clotting can also happen within the vessels that supply your heart and brain with blood. If your blood vessels are already narrowed from atherosclerosis — the buildup of fatty deposits in your arteries — a fatty deposit in your vessel can burst. Then, a blood clot can quickly form and block the artery. This prevents blood flow to the heart or brain and causes a heart attack or stroke. Aspirin therapy reduces the clumping action of platelets — possibly preventing heart attack and stroke.

Does daily aspirin therapy differ between men and women?

Aspirin can have different effects between the sexes, and for women, among age groups.
For men of all ages, aspirin can:

Prevent a first and second heart attack
Reduce heart disease risk
For women younger than 65, aspirin can:
Prevent a first stroke
Prevent a second heart attack
Reduce heart disease risk
For women 65 and older, aspirin can:
Prevent a first and second heart attack
Prevent a first stroke
Reduce heart disease risk

The risk of bleeding with daily aspirin therapy, however, is about the same in both sexes.

Should you take a daily aspirin?

Whether you need daily aspirin therapy depends on your risk of heart disease and stroke. Risk factors for a heart attack or stroke include:

Smoking tobacco
High blood pressure — a systolic pressure of 140 millimeters of mercury (mm Hg) or higher or a diastolic pressure of 90 mm Hg or higher
Total cholesterol level of 240 milligrams per deciliter (mg/dL) — 6.22 millimoles per liter (mmol/L) — or higher
Low-density lipoprotein ("bad") cholesterol level of 130 mg/dL (3.37 mmol/L) or higher
Lack of exercise
Having more than two alcoholic drinks a day for men, one drink a day for women
Family history of a stroke or heart attack
If you've had a heart attack or stroke, chances are your doctor has talked to you about taking aspirin to prevent a second occurrence.

If you have strong risk factors, but have not had a heart attack or stroke, you may also benefit from taking an aspirin every day. First, you'll want to discuss with your doctor whether you have any conditions that make taking aspirin dangerous for you.

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