Some people taking daily aspirin should cut back to two or three doses a week.
That’s the advice of one of the nation’s top cardiologists in the wake of a new warning from the Food and Drug Administration this week that too many Americans are taking aspirin every day, opening themselves to risks of bleeding in the stomach and brain.
The FDA said that aspirin shouldn’t be used to prevent heart attacks or stroke in people with no history of heart disease.
“Based on my 30 years of practice I can tell you that a large number of heart attacks happen in people without underlying coronary heart disease. Up to 50 percent of people who have their first heart attack don’t have diagnosed heart disease,” he tells Newsmax Health.
“Aspirin can prevent these first heart attacks – so people should not stop taking it.”
He recommends that those over age 50 with no heart disease history take a low-dose or baby aspirin (81 mg) two to three days a week. “That way, they will get the benefits of aspirin without the risks,” Dr. Crandall said.
For patients who’ve had a heart attack or show other signs of heart disease, he advises taking a low-dose aspirin every day, preferably in the morning after eating.
“Aspirin is a lifesaving drug with a long safety record,” said Dr. Crandall, chief of the cardiac transplant program at the world-renowned Palm Beach Cardiovascular Clinic.
An estimated 40 million Americans take low-dose aspirin daily. The FDA noted that aspirin, which is a blood thinner, increases the risk for potentially serious complications, including bleeding and gastrointestinal problems.
The benefits of aspirin on the heart have been known for decades, but its use for heart attack prevention became widespread following the 1995 finding of the Physician’s Health Study which found low-dose aspirin decreased the risk of a first myocardial infarction by 44 percent. This made aspirin a mainstay in the arsenal of cardiologists.
“We have a better understanding of heart disease now,” said Dr. Crandall, who says he has become even more convinced of the drug’s benefits in the almost 20 years since the study.
“Originally, we thought that aspirin could help prevent heart attacks from spasms of the coronary arteries, but we now know that a heart attack is caused when a piece of plaque on the artery ruptures, causing a blood clot. Aspirin can prevent that clot from forming,” he said.
Aspirin also has anti-inflammatory properties, which act against what is now believed to be the key driver of coronary heart disease.
Beside heart attack prevention, “aspirin has a lot of other benefits as well,” Dr. Crandall said. Research has shown that it helps prevent colon cancer and osteoarthritis.