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Daily Aspirin: Take It The Right Way


Aspirin can be a lifesaver when it comes to preventing heart attacks, but it’s crucial to take it correctly, says one of the nation’s top cardiologists.

Chauncey Crandall, M.D., chief of the cardiac transplant program at the world-renowned Palm Beach Cardiovascular Clinic, recommends that most people over 50 take aspirin regularly. But he says it is important to take the right dose, at the right time, for your particular health situation.

The U.S. Food and Drug Administration recently issued new guidelines saying people without a history of heart disease should not take aspirin regularly because of risks of stomach and brain bleeding.

But Dr. Crandall said there is wide disagreement among cardiologists about the new government warning.

“The regulators are the only ones who have a problem with aspirin,” said Dr. Crandall, author of the No. 1 Amazon best-seller The Simple Heart Test. “The doctors on frontlines in the battle against heart disease know that aspirin works and that there is little risk if it is taken in the right way. In my 30 years of practice, I have never had a patient who had bleeding problems because of aspirin.”

Here is Dr. Crandall’s advice about how to take aspirin to prevent heart attack:

  • If you are a heart attack survivor or you have a history of heart disease, take one low-dose (81 mg) aspirin daily.
  • If you are over 50 and have no history of heart disease, take a low-dose aspirin two or three times a week.
  • Take aspirin in the morning. That’s when most heart attacks occur. It’s best to take it on a full stomach after eating breakfast.
  • If you don’t have low-dose aspirin, you can break a regular aspirin (325 mg) into quarters, although this can be difficult with some tablets.
  • If you take a blood thinner like Coumadin (warfarin), or Plavix (clopidogrel), or one of the newer anticoagulants, like Effient (prasugrel), Pradaxa (dabigatran), Xarelto (rivaroxaban), or Eliquis (apixaban), talk to your doctor before you start taking aspirin regularly.
  • Before a plane flight, long car trip, or other situation where you’ll be seated for an extended time, take one regular (325 mg) aspirin the day before you go. This can prevent a blood clot from forming in the legs, a condition called deep vein thrombosis, which can be deadly.
  • If you think you could be having a heart attack, chew (don’t swallow) two regular (325 mg) aspirin. Uncoated is best, but use any kind you have on hand. If you only have low-dose aspirin, chew five.
  • Taking aspirin along with fish oil and/or vitamin E may cause bruising, especially in the elderly. If you notice bruising, cut back on fish oil and vitamin E.
  • Most people can take aspirin safely, but if you are undergoing chemotherapy or have a blood disorder, taking aspirin regularly may not be safe. Check with your doctor first.
  • If you can’t take aspirin because you are one of the rare people who are allergic to it, there is an alternative. It’s called nattokinase, an enzyme extracted and purified from a Japanese food called nattō. Ask your doctor or alternative medicine practitioner about it.
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