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 heart 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 can cause serious internal bleeding. Bleeding can happen even in people who have safely taken aspirin for a long time.

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.

Some people have a higher risk of bleeding while taking aspirin than other people. You are more likely to bleed while taking aspirin if you:

●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, or "NSAIDs." These include naproxen (sample brand name: Aleve) and 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 as a cream or lotion 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)

Using aspirin every day can also increase the risk of low iron and anemia in older people. Anemia means having too few healthy red blood cells.

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). Experts aren't sure why aspirin might help prevent cancer, but some studies suggest that it does.

What dose of aspirin can protect me? — 

Experts think that 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 should I 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. This means that 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? — 

This is a decision you will make with your doctor or nurse. In people who have never had a heart attack, the downsides of taking aspirin can be greater than the benefits. This is especially likely if you are over age 70.

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.

●If you are already taking aspirin, ask your doctor or nurse if you should keep taking it.

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

If you 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)