You’ve probably heard that taking a daily baby aspirin (81 mg) prevents heart attacks.But is that recommendation meant for everyone?

The answers are found in a March 2009 report by the U.S. Preventive Services Task Force (USPSTF) published in The Annals of Internal Medicine (2009, March 17;150:396.) 

The first issue of interest is that a recent study showed no benefit of aspirin in the prevention of heart attacks in women, despite preventing heart attacks in men. But, a daily aspirin has been shown to prevent strokes in women. So, a daily aspirin is recommended for women to prevent strokes, but not necessarily heart attacks, as it is in men.

The other recommendations by the USPSTF concerning who should take a daily aspirin include:

1) women between the ages of 55 and 79, and men, ages 45-79;

2) women and men, with and without risk factors for cardiovascular disease ( such as high blood pressure and high cholesterol); and

3) those people whose risk of bleeding from the gastrointestinal track is less than their risk of having a heart attack or stroke.   

How to figure out that last part of the recommendation?  We know that a daily aspirin increases the risk of GI bleeding. That risk is increased even more in men, older people (over 80 yo), people with a history of ulcer disease or upper GI pain, and those who regularly take a nonsteroidal anti-inflammatory drug, such as ibuprofen. Therefore, before simply popping an aspirin daily, you should discuss with your health care provider your risk of bleeding from the GI track; this is especially so if you are over 80 years old. Also, you should not take a daily aspiring if you are allergic to it.

Bottom line: a daily aspirin helps to prevent strokes in women and heart attacks in men, who are in the appropriate age range. If you are in the appropriate age range, and are not allergic to it, you should be taking a daily baby aspirin (81 mg) as long as the benefits outweigh the risk of GI bleeding. If you are younger than 55, but have risk factors for strokes and heart disease (a family history, high blood pressure, diabetes, high cholesterol, to name a few), then speak with your doctor about your need to take a daily aspirin.