Caution urged for non-heart attack patients taking daily aspirin

At Martin ORiordans cardiology practice in the Philadelphia area, it happens weekly.

A 45- or 50-year-old patient mentions that her father had a heart attack at the same age. Worried that the same fate will befall her despite being in good health, she takes baby aspirin every day.

ORiordans typical response: Please stop.

Physicians have known for decades that daily, low-dose aspirin makes sense for patients who have had a heart attack or stroke, as it sharply reduces the chance of having a second one.

But for people who have never had one of these cardiovascular events, the thinking on aspirin is less clear, despite two recent large-scale studies. The reason for caution is the very reason that aspirin wards off heart attacks and strokes: It interferes with blood clotting, putting the patient at higher risk of serious gastrointestinal bleeding.

Bottom line: Aspirin is more potent than many people realize, said ORiordan, of Mercy Cardiology.

People have kind of looked at it as, Aspirin, an apple, a glass of milk, its all good for you, said ORiordan, who is on staff at Lankenau Medical Center. Aspirin is a medication.

It is a medication drawing renewed scrutiny, 30 years after the Food and Drug Administration approved its use after a heart attack.

Evidence suggests it is also a good idea for some people who have not had a heart attack but who are at risk of having one those with multiple risk factors such as high cholesterol, high blood pressure or diabetes. But the FDA has not approved it for that use.

And no one is precisely sure at what point aspirins benefits outweigh the risk of bleeding, said J. Michael Gaziano, chief of the division of aging at Brigham and Womens Hospital in Boston.

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Caution urged for non-heart attack patients taking daily aspirin