Patient education: Aspirin to prevent heart attacks and cancer (The Basics)

Can aspirin prevent health problems? — Yes, aspirin can prevent a few different health problems in certain people. For example, in people who have had a heart attack or stroke, aspirin can help prevent another heart attack or stroke. Studies also suggest that aspirin might prevent heart attacks in people who have never had a heart attack or any type of heart or blood vessel disease. Plus, aspirin might protect against some forms of cancer. The type of cancer that aspirin seems to help most with is cancer of the colon or rectum (the lower part of the bowel).

Can aspirin cause health problems? — Yes, aspirin has a downside. It can cause serious internal bleeding. When aspirin causes bleeding, it is usually in the stomach or intestines. But bleeding can also happen in other parts of the body, such as the brain.

The risk of bleeding while taking aspirin is not the same for everyone. Some people have a higher risk than others.

You are more likely to bleed while taking aspirin if you:

●Have had ulcers in your stomach or intestines (called peptic ulcers)

●Are 65 years old or older

●Take high doses of medicines called nonsteroidal antiinflammatory drugs (NSAIDs), such as naproxen (sample brand name: Aleve) or ibuprofen (sample brand names: Advil, Motrin)

●Use medicines called corticosteroids in the form of pills or shots. (It doesn't matter if you use these medicines in a cream or lotion that you put on your skin.)

●Take medicines called "anticoagulants" or blood thinners, such as:

•Warfarin (brand name: Jantoven)

•Dabigatran (brand name: Pradaxa)

•Apixaban (brand name: Eliquis)

•Edoxaban (brand names: Savaysa, Lixiana)

•Rivaroxaban (brand name: Xarelto)

How does aspirin prevent health problems? — Aspirin can help prevent health problems that affect the heart or blood vessels because it helps prevent blood clots. Heart attacks and some strokes happen when blood clots form inside arteries. Aspirin helps keep that from happening (figure 1). When it comes to cancer, experts aren't sure why aspirin might help, but results of some studies suggest that it does.

What dose of aspirin can protect me? — Experts think the best dose to prevent health problems is 75, 80, or 100 milligrams a day. This is often called "low-dose" aspirin. It is much less than the 325 milligram dose in an aspirin pill that is used to treat pain or fever.

How long do I have to take aspirin? — People who choose to take aspirin to prevent heart attacks or cancer need to take it for many years. Aspirin starts preventing blood clots almost as soon as you take it. That means it can protect against heart attacks right away, but the protection wears off if you stop taking aspirin. It takes several years before aspirin protects against cancer.

Should I take aspirin to prevent health problems? — That is a decision you will have to make with your doctor. Here are some steps you can take:

●Ask your doctor or nurse if you might benefit from taking aspirin

●Ask if you would be at risk of bleeding if you took aspirin

●Depending on the answers, work with your doctor or nurse to make a decision that is right for you

If you have already had a heart attack, the decision you make with your doctor or nurse will be different.

More on this topic

Patient education: Heart attack (The Basics)
Patient education: Medicines after a heart attack (The Basics)
Patient education: Atherosclerosis (The Basics)
Patient education: Colon and rectal cancer (The Basics)

Patient education: Aspirin in the primary prevention of cardiovascular disease and cancer (Beyond the Basics)
Patient education: Heart attack (Beyond the Basics)
Patient education: Colon and rectal cancer (Beyond the Basics)