By Gary Melis R.Ph., registered pharmacist at Network Health
11/20/2023
Have you ever heard that taking a low-dose aspirin each day can help prevent cardiovascular disease and its effects, like a heart attack or stroke? It’s one of those medical remedies that many of us have heard of, even if we hadn’t necessarily heard it from our personal doctor.
So, does it work? Well, last year, the U.S. Preventive Services Task Force (USPSTF) released its final recommendations on using low-dose aspirin for this purpose.
But the answer is a bit more complicated than a simple “yes” or “no.” To understand the recommendation, it’s important to first understand the difference between primary and secondary prevention.
Primary prevention of cardiovascular disease relates to people who have not had a history of the disease. You would fit in this category if you have never had a heart attack or stroke, never had coronary bypass surgery or other related surgeries and never had blocked arteries.
Secondary prevention relates to people who have had a heart attack, stroke or a medical history that includes any of the other conditions mentioned previously. This will also apply to you if you have heart or blood vessel disease.
In 2022, the USPSTF provided new guidance on low-dose aspirin use for cardiovascular disease prevention. The recommendation is that people over the age of 60 should not use a low-dose aspirin regimen for the purpose of cardiovascular disease prevention if they have no history of the disease. Those age 40-59 who are at a high risk for a heart attack or stroke due to risk factors like hypertension, Type 2 diabetes and smoking, may consider taking low-dose aspirin with a recommendation from their personal doctor.
The guidance remains unchanged for secondary prevention. Those who are taking low-dose aspirin due to a medical history of heart attack, stroke or stenting should continue to do so as directed by their doctor.
That last part is key. Regardless of medical history, you should consult with your personal doctor before starting or stopping a low-dose aspirin regimen.
[Read more: Heart Medications Are Common, but So Are Their Myths]
Though aspirin is a widely used medicine, it isn’t for everyone, and the reasons go beyond using it for primary versus secondary prevention.
The side effects of aspirin can be severe for some people. Up to 10 percent of people who take aspirin experience several symptoms including nausea, vomiting and stomach bleeding. Some people may even experience problems with their kidney, liver or nervous symptoms.
Some people should generally avoid taking aspirin altogether, especially those with an allergy to aspirin, a bleeding disorder or uncontrolled high blood pressure. As always, a consultation with your personal doctor is the best bet before taking any new medications.
If you and your doctor decide to begin a low-dose aspirin regimen, your doctor can recommend an appropriate dosage for you. But since aspirin is available over the counter, it’s important to select the correct product at your pharmacy.
Both full-strength and low-dose aspirins are generally available. Low-dose aspirin may range from 75-100 milligrams (mg), though 81 mg is typical. Discuss with your doctor how many aspirin to take daily. Full-strength aspirin is typically 325 mg, likely exceeding the dosage recommended by your doctor.
If you have a plan with Network Health, we’d be happy to help you better understand the pharmacy benefits specific to your plan. Just call us at the number on the back of your Network Health member ID card.