Taking an aspirin every day can be a lifesaving option for people already diagnosed and managing coronary artery disease, but it’s not a good idea for everyone.
Coronary artery disease (CAD) is a type of heart disease that occurs when arteries near the heart narrow due to a buildup of plaque, cholesterol, of fatty deposits over time. This narrowing can be dangerous if it restricts blood flow to the heart, leading to a heart attack.
For decades, doctors prescribed low dose (baby) aspirin to help lower the risk of a first heart attack or stroke in people with heart disease or to prevent the development of heart disease in the first place. However, recent studies haven’t been clear on the benefits. In fact, research suggests daily aspirin could raise your risk of internal bleeding, which can be life threatening.
For this reason, daily aspirin is no longer broadly recommended for healthy adults, especially those under 40 or over 59, and anyone with an increased risk of bleeding.
But new expert recommendations are a bit more nuanced for those with a very high risk of heart disease.
If you’ve already experienced a heart attack, stroke, or had surgery for CAD, taking a low dose of aspirin every day could save your life. Aspirin can help prevent blood clots that can stop blood flow to the heart or brain.
Here we detail current guidelines for using aspirin to treat or prevent CAD, including when the benefits outweigh the risks.
Always speak with your doctor before taking daily low dose aspirin.
Is aspirin good for managing or treating coronary artery disease?
Over 20 million U.S. adults have CAD, also called coronary heart disease or ischemic heart disease. Heart disease is the leading cause of death in the United States.
Taking a daily low dose of aspirin (75 to 100 milligrams) used to be recommended for managing or preventing coronary artery disease (CAD). But an increasing body of research, such as this 2019 study , shows that daily aspirin comes with serious bleeding risks and may not offer any protection against stroke and heart attack.
The American Heart Association (AHA) and the U.S. Preventive Services Task Force (USPSTF) have updated their recommendations based on this new research. According to new USPSTF recommendations , daily aspirin is thought to only provide enough benefit to outweigh the potential risks in:
Is aspirin good for preventing coronary artery disease?
The AHA and USPSTF now recommend against taking low dose aspirin daily for the primary prevention of CAD for most adults, as new studies suggest that the benefits don’t outweigh the risks.
Low dose aspirin might be considered for some adults between 40 and 59 who are at a higher risk of CAD but not at an increased risk of bleeding.
In the updated guidelines, the AHA notes that the most important way to prevent heart disease is with a healthy lifestyle.
Read more about heart-healthy lifestyle habits for preventing and managing CAD .
Potential risks and side effects of taking aspirin for coronary artery disease
Daily aspirin is usually safe, but there are a few risks and side effects, some of which can be life threatening.
Side effects and complications of taking daily aspirin include:
- gastrointestinal bleeding
- stomach ulcers
- hemorrhagic stroke
- allergic reaction
- interactions with certain herbs, supplements, and medications, which increases bleeding risk
- risk of bleeding during minor surgeries, including dental procedures
- anemia
Who should not take aspirin to treat, manage, or prevent coronary artery disease?
Aspirin is no longer recommended if you’ve never had a heart attack or stroke, with a few exceptions. You should avoid taking aspirin to prevent CAD unless your doctor thinks you could benefit from it after a careful evaluation of your overall health and risk factors .
If you have heart disease but have never had a heart attack or stroke, you shouldn’t take aspirin if you:
- are under 40 or over 59 years old
- have an underlying condition that increases your risk of bleeding, such as:
- gastrointestinal bleeding
- peptic ulcer disease
- blood clotting problems
- kidney disease
- are allergic to aspirin
- drink alcohol regularly
- are undergoing surgical or dental procedures
Anyone with a history of heart attack, stroke, stent placement, or coronary bypass surgery should continue taking aspirin as prescribed by their doctor.
What is the first-line treatment for coronary artery disease?
First-line treatment for coronary artery disease (CAD) depends on your overall health and risk factors. It often includes both lifestyle and diet changes, in addition to medications.
Examples of lifestyle changes recommended by the AHA for the prevention and treatment of CAD include:
Your doctor may also prescribe medications to help treat high cholesterol, lower your blood pressure, or control your blood sugar.
Learn more about medications for CAD .
When to contact a doctor
The risk of heart disease increases as you get older. The AHA recommends that adults over 40 should visit their doctor regularly to discuss their risk for heart disease and any preventive interventions.
If you’ve already been diagnosed with CAD, it’s important to schedule regular appointments with your doctor to discuss medications and lifestyle changes to prevent a heart attack or stroke.
Call emergency medical services or go to the nearest emergency room if you or someone you’re with experiences the following symptoms. These symptoms could mean you’re having a heart attack or stroke .
- chest pain or pressure, which may spread to the arm or shoulder
- rapid heart rate
- shortness of breath
- dizziness
- leg pain
- lightheadedness or fainting
- sudden confusion
- feeling of impending doom
- unusual fatigue
- clamminess or sweating
- loss of balance
- difficulty speaking or slurred speech
- numbness or weakness
- vision problems
Frequently asked questions about taking aspirin for heart disease
Expert recommendations for taking aspirin for heart disease have changed recently. Here are answers to some frequently asked questions about aspirin and heart disease.
Do cardiologists still recommend aspirin for heart disease?
Cardiologists still recommend daily low dose aspirin for some people with heart disease, especially those who have already had a heart attack, stroke, stent placement, or coronary artery bypass surgery.
Aspirin isn’t recommended if you’ve never had a heart attack or stroke, unless your doctor thinks you could benefit from it after a careful evaluation of your overall health and risk factors.
Risk factors for heart disease include smoking, a strong family history of heart attack, uncontrolled blood pressure, cholesterol, or diabetes. But each person’s risk is different. Always speak with a doctor before starting aspirin.
Is aspirin good for heart attack prevention?
If you’ve never had a heart attack before, aspirin isn’t recommended for most people to prevent it. Aspirin should be limited to people at the highest risk of heart attack and a very low risk of bleeding. Don’t start taking aspirin before speaking with a doctor.
However, if you’ve had a heart attack in the past, taking a low dose aspirin could help prevent another heart attack or stroke.
Is aspirin good for heart failure?
There’s no clear consensus among experts on the benefits of taking aspirin to treat heart failure. Studies show conflicting results regarding the benefits and risks of aspirin use.
A 2021 study found that taking aspirin could help lower the rate of hospitalization for heart failure, but more research is needed.
Takeaway
Speak with a doctor about taking aspirin to treat or prevent heart disease. If you’ve had a heart attack or stroke, stent placement, or bypass surgery, your doctor may want you to take a daily low dose of aspirin to help prevent another.
Because of the risk of bleeding, aspirin is no longer broadly recommended if you’ve never had a heart attack or stroke. If you’re between 40 and 59, at low risk of bleeding, and at high risk of heart disease, you might benefit from aspirin. But only a doctor can decide whether taking low dose aspirin makes sense for you.
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