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Aspirin and heart disease

Current guidelines recommend that people with coronary artery disease (CAD) receive antiplatelet therapy with either aspirin or clopidogrel.

Aspirin therapy is very helpful for people with CAD or a history of stroke. If you have been diagnosed with CAD, your health care provider may recommend that you take a daily dose (from 75 to 162 mg) of aspirin. A daily dose of 81 mg is recommended for people who have had PCI (angioplasty). Aspirin can reduce the risk for heart attack and ischemic stroke. However, using aspirin over the long-term can raise your risk for stomach bleeding.

Daily aspirin should not be used for prevention in healthy people who are at low risk for heart disease. You provider will consider your overall medical condition and risk factors for heart attack before recommending aspirin therapy.

How Aspirin Helps You

Taking aspirin helps prevent blood clots from forming in your arteries, and may help lower your risk for a stroke or heart attack.

Your provider may recommend to take daily aspirin if:

  • You do not have a history of heart disease or stroke, but you are at high risk for a heart attack or stroke.
  • You have been diagnosed with heart disease or stroke already.

Aspirin helps get more blood flowing to your legs. It can treat a heart attack and prevent blood clots when you have an abnormal heartbeat. You probably will take aspirin after you have treatment for clogged arteries.

Developmental process of atherosclerosis

You will most likely take aspirin as a pill. A daily low-dose aspirin (75 to 81 mg) is most often the first choice for preventing heart disease or stroke.

Talk to your provider before taking aspirin every day. Your provider may change your dose from time to time.

Side Effects

Aspirin can have side effects such as:

  • Diarrhea
  • Itching
  • Nausea
  • Skin rash
  • Stomach pain

Before you start taking aspirin, tell your provider if you have bleeding problems or stomach ulcers. Also say if you are pregnant or breastfeeding.

Taking Aspirin

Take your aspirin with food and water. This can reduce side effects. You may need to stop taking this medicine before surgery or dental work. Always talk to your provider before you stop taking this medicine. If you have had a heart attack or a stent placed, be sure to ask your heart doctor if it is OK to stop taking aspirin.

You may need medicine for other health problems. Ask your provider if this is safe.

If you miss a dose of your aspirin, take it as soon as possible. If it is time for your next dose, take your usual amount. DO NOT take extra pills.

Store your medicines in a cool, dry place. Keep them away from children.

When to Call the Doctor

Call your provider if you have side effects.

Side effects can be any signs of unusual bleeding:

  • Blood in the urine or stools
  • Nosebleeds
  • Unusual bruising
  • Heavy bleeding from cuts
  • Black tarry stools
  • Coughing up blood
  • Unusually heavy menstrual bleeding or unexpected vaginal bleeding
  • Vomit that looks like coffee grounds

Other side effects can be dizziness or difficulty swallowing.

Call your provider if you have wheezing, breathing difficulty, or tightness or pain in your chest.

Side effects include swelling in your face or hands. Call your provider if you have itching, hives, or tingling in your face or hands, very bad stomach pain, or a skin rash.

Alternative Names

Blood thinners - aspirin; Antiplatelet therapy - aspirin

References

Amsterdam EA, Wenger NK, Brindis RG, et al. 2014 AHA/ACC guideline for the management of patients with non-ST-elevation acute coronary syndromes: a report of the American College of Cardiology/American Heart Association Task Force on practice guidelines. J Am Coll Cardiol. 2014;64(24):e139-e228. PMID: 25260718 www.ncbi.nlm.nih.gov/pubmed/25260718.

Fihn SD, Gardin JM, Abrams J, et al. 2012 ACCF/AHA/ACP/AATS/PCNA/SCAI/STS guideline for the diagnosis and management of patients with stable ischemic heart disease: a report of the American College of Cardiology Foundation/American Heart Association task force on practice guidelines, and the American College of Physicians, American Association for Thoracic Surgery, Preventive Cardiovascular Nurses Association, Society for Cardiovascular Angiograpy and Interventions, and Society of Thoracic Surgeons. Circulation. 2012;126(25):e354-e471. PMID: 23166211 www.ncbi.nlm.nih.gov/pubmed/23166211.

Lansberg MG, O'Donnell MJ, Khatri P, et al. Antithrombotic and thrombolytic therapy for ischemic stroke: Antithrombotic Therapy and Prevention of Thrombosis, 9th ed: American College of Chest Physicians evidence-based clinical practice guidelines. Chest. 2012;141(2 Suppl):e601S-e636S. PMID: 22315273 www.ncbi.nlm.nih.gov/pubmed/22315273.

O'Gara PT, Kushner FG, Ascheim DD, et al. 2013 ACCF/AHA guideline for the management of ST-elevation myocardial infarction: executive summary: a report of the American College of Cardiology Foundation/American Heart Association Task Force on practice guidelines. Circulation. 2013;127(4):529-555. PMID: 23247303 www.ncbi.nlm.nih.gov/pubmed/23247303.

Ridker PM, Libby P, Buring JE. Risk markers and primary prevention of coronary heart disease. In: Mann DL, Zipes DP, Libby P, Bonow RO, Braunwald E, eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 10th ed. Philadelphia, PA: Elsevier Saunders; 2015:chap 42.

Vandvik PO, Lincoff AM, Gore JM, et al. Primary and secondary prevention of cardiovascular disease: Antithrombotic Therapy and Prevention of Thrombosis, 9th ed: American College of Chest Physicians evidence-based clinical practice guidelines. Chest. 2012;141(2 Suppl):e637S-e668S. PMID: 22315274 www.ncbi.nlm.nih.gov/pubmed/22315274.

Review Date 8/2/2016

Updated by: Michael A. Chen, MD, PhD, Associate Professor of Medicine, Division of Cardiology, Harborview Medical Center, University of Washington Medical School, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.

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