The recent news about who should and who shouldn't take a daily aspirin has caused confusion because many headlines made it sound like you should stop.
The correct answer is: It depends on your health (for example, body weight seems to alter the benefits and risks of daily aspirin) and why you are taking aspirin (there are more reasons than just heart health).
So let us break it down, so you can talk to your doctor about what's right for you.
Turns out more than 6 million folks in the U.S. take daily aspirin without a doc's recommendation. If that describes you, go to see your primary care physician or cardiologist pronto to find out if you should be taking it and if you are taking it correctly: That's always with a half a glass of warm water, tea or coffee before and after. A daily aspirin does increase the risk of gastrointestinal bleeding, so the risk-benefit ratio has to land in your favor!
New Recommendations
According to a new study published in the Annals of Internal Medicine, in 2017 about 29.9 million Americas age 40 and older took a daily aspirin to prevent or manage heart disease, and that includes around 10 million heart-healthy 70-year-olds who take aspirin to prevent its onset. Some folks do not need to and should not take a daily aspirin to prevent heart disease, even though their doctor had previously recommended it. That's:
- Anyone 70+ who does NOT have existing cardiovascular disease.
- Anyone with an increased bleeding risk because of other medications or conditions such as an ulcer, or who does extreme sports or doesn't use a car seatbelt or wear a helmet when skiing/biking/blading.
- Folks under 70, on an individual basis, whose risk of heart disease is low or moderate. Turns out individual bleeding risks vary widely, and that's why for these folks it's a case-by-case decision made with their doctor.
A plant-based diet, regular physical activity, not smoking (anything) and healthy sleep habits go a long way in preventing heart disease!
So who should be taking aspirin for heart disease?
If you are at high risk for heart disease or have already had a heart attack, severe angina or a stroke, aspirin's benefits can save your life!
Who should be taking aspirin for other reasons?
Aspirin is not only effective in slashing the risk for a second heart attack or stroke, it also reduces by more than 20% the risk of colorectal, esophageal, stomach, breast, liver and pancreatic cancer, as well as blood cell cancers. There are ways to reduce the internal bleeding risks associated with taking daily aspirin: A 2018 study that looked at more than 600,000 folks for up to 14 years found daily low-dose aspirin significantly reduces the risk of colon cancer and the increased gastrointestinal bleeding risks can be reduced with the use of medicines that suppress stomach acid. (Hey, drink that warm beverage before and after taking it, too.)
Those benefits (plus prevention of cardiovascular and inflammatory disease) are why Dr. Mike recommends most men over 35 and women over 45 should check with their doc about taking one low-dose aspirin in the morning and one in the evening.
Next steps?
If you think it may be smart to stop taking your daily aspirin, talk with you doc about tapering off. Don't stop abruptly and risk a rebound effect that makes you more vulnerable to stroke or heart attack. If it sounds like you're a candidate for a daily aspirin regimen for your heart health or to reduce your cancer risk, again, ask your doc.
(c)2019 Michael Roizen, M.D. and Mehmet Oz, M.D.