If you do not have heart disease, taking once daily aspirin to protect your heart may do more harm than good, according to new research. Daily aspirin can help prevent heart attacks, but in patients without previous heart trouble, the risk of internal bleeding caused by aspirin is greater than the possible benefit.

Aspirin can prevent blood clots from forming, which reduces the risk of heart attack. On the other hand, if you have internal bleeding, clots help prevent that bleeding from getting worse. Because aspirin inhibits clots from forming, a small bleed can turn into a more serious one if you are taking daily aspirin.

The guidelines

The American College of Cardiology and American Heart Association came out with specific new guidelines for aspirin in adults, which USA Today summarized this way:

• People over 70 who don’t have heart disease – or are younger but at increased risk of bleeding – should avoid daily aspirin for prevention of heart disease.
• Only certain 40- to 70-year-olds who don’t have heart disease are at high enough risk to warrant 75 to 100 milligrams of aspirin daily, and that’s for a doctor to decide.

Talk with your doctor

Even with these guidelines established, it’s good to have a conversation with your provider about an aspirin regimen.

“Every person and their lifestyle are unique. So even though there are guidelines about aspirin use, a one-on-one conversation with a provider who knows you and your medical history is important,” said Dr. Shereif Rezkalla, Marshfield Clinic Health System cardiologist.

Rezkalla added that for people younger than 40, the risk of heart disease is generally low, and people in that age range are unlikely to benefit from aspirin.

A balancing act

“The whole thing is a balancing act between benefit and risk,” Rezkalla said. “If you’re a 41-year-old man who smokes, is obese and doesn’t exercise, you may benefit from taking aspirin to prevent heart attack. But if that man’s sister or brother is the same age, and lives a healthier lifestyle and has low risk factors for heart disease, they should not take daily aspirin.”

If you have any questions about the risks and benefits of daily aspirin, talk with your provider.