Aspirin for heart: Benefits and risks

Aspirin, also known as acetylsalicylic acid (ASA), is a widely used medication with multiple therapeutic properties. It is mostly prescribed to provide pain relief, help in reduction of inflammation, and fever reduction. It is basically effective in alleviating common types of pain such as headaches, muscle aches, and toothaches. Low-dose aspirin was also recommended to older adults in order to prevent heart disease. But a few years ago, experts stopped recommending it due to its potential side effects. However, a new study has revealed that many older adults are still taking aspirin for heart health. But is it safe?

Study on aspirin for heart health

Nearly 30 percent of people aged 60 and older in the US who don’t have cardiovascular disease take aspirin on a daily basis to prevent stroke and heart attack, according to a study published in the Annals of Internal Medicine journal in June 2024. The figure comes as a shock, as the American College of Cardiology and American Heart Association had updated their recommendations in 2019. They had shared that aspirin should be used infrequently in the routine primary prevention of heart disease due to a “lack of net benefit”.

A research published in Annals of Internal Medicine in 2023 had also shown that daily aspirin therapy could increase the risk of excessive bleeding in people with no history of heart problems.

What are the benefits of aspirin for heart health?

Aspirin helps the heart primarily by its antiplatelet effects, which prevent blood clots, says internal medicine expert Dr Vidhe Sharma. Here’s how it works:

1. Inhibition of platelet aggregation

Platelets are very small cell fragments in your blood that help it clot when you get injured. Aspirin inhibits an enzyme known as cyclooxygenase (COX), which in turn reduces the production of thromboxane A2, a substance that causes platelets to clump together. By preventing platelets from clumping, this medicine reduces the formation of blood clots.

2. Improving blood flow

By reducing the likelihood of blood clots, aspirin ensures smoother blood flow through the arteries. This is particularly beneficial in arteries that supply the heart and brain, as clots here can lead to heart attacks or strokes, says the expert.

3. Reducing inflammation

Aspirin’s anti-inflammatory properties can help reduce inflammation in the arterial walls. Lower inflammation levels can ultimately contribute to overall better cardiovascular health.

What are the risks of using aspirin for the heart?

Daily aspirin therapy can be beneficial for some people, but it also comes with potential risks. Here are the key risks associated with taking aspirin every day –

1. Gastrointestinal bleeding

Aspirin can irritate the lining of the stomach and intestines, potentially leading to ulcers and gastrointestinal bleeding. This is especially risky for people with a history of ulcers or gastrointestinal issues, says Dr Sharma.

2. Hemorrhagic stroke

While aspirin helps prevent ischemic strokes caused by blood clots, it can increase the risk of hemorrhagic strokes caused by bleeding. This happens because aspirin’s blood-thinning properties could potentially lead to bleeding in the brain.

3. Allergic reactions

Some individuals may be allergic to medicines like aspirin. This can lead to symptoms such as hives, swelling on different parts of the body, and difficulty breathing.

4. Kidney issues

Long-term use of aspirin that too every day can sometimes affect kidney function. People with pre-existing kidney conditions have higher chances of experiencing this problem.

5. Increased risk of bleeding

Because aspirin thins the blood, it can make it more difficult to stop bleeding if you get injured. This can also pose risks during surgeries or other medical procedures.

6. Interactions with other medications

Aspirin can interact with other medications, such as blood thinners (warfarin), and nonsteroidal anti-inflammatory drugs (NSAIDs). This can increase the risk of bleeding, says the expert.

How to reduce the risk of heart disease?

Here are some safer and effective ways to reduce heart disease risk:

1. Healthy diet

Eat a variety of nutrient-rich foods such as fruits, and vegetables, suggests the expert. Choose healthier fats like those found in fish, nuts, and olive oil. Reduce salt intake, as excess sodium can raise blood pressure.

2. Exercise regularly

Include aerobic exercises in your fitness routine to stay healthy. Doing strength training at least twice a week is also beneficial for your overall health, including your heart.

3. Maintain a healthy weight

Losing excess weight can lower blood pressure, cholesterol levels, and reduce the strain on the heart, says the expert. So, monitor your weight and body mass index to know if you need to lose weight.

4. Quit smoking

Smoking is considered to be a major risk factor for heart disease. Seek support to quit smoking through resources such as counseling, medication, or smoking cessation programmes. Your family members and friends, especially non-smokers, can be of great help too.

5. Get regular health screenings

Regular health check-ups with your doctor help catch risk factors like high blood pressure, high cholesterol, and diabetes early. If you have conditions like hypertension, diabetes, or high cholesterol, work with your doctor to manage them effectively through medication and lifestyle changes.

There are potential risks associated with daily aspirin therapy for heart health. So, focus on a healthy diet and lifestyle to prevent heart disease.