Can Taking Aspirin Prevent Me From Becoming Sick?

The short answer is probably not.

In 2017 and 2018 I wrote blogs discussing what the role for taking aspirin was as a preventative measure against stroke, heart attack, vein blood clots and even colon cancer.

Back then and even now, daily, lifelong low dose (81mg) aspirin IS absolutely recommended for nearly everyone who has already had a stroke, heart attack, vein blood clot and for anyone who has undergone a cardiovascular procedure such as stent or bypass of a diseased artery or vein.  Taking an aspirin daily under these circumstances does reduce the possibility of a SECOND event from happening.

In the past 15 years, many studies have been performed to determine if taking a daily aspirin, provided you have NOT had any of the above blood vessel events or procedures, would prevent having a first episode or a first procedure.

In doing these important studies, it was immediately appreciated that all patients do not have the same risk factors (age, diabetes, high cholesterol, known family history) for cardiovascular disease.  So a system to calculate the risk of having a cardiovascular event over the next 10 years was developed.  There are several of these “risk calculators” available on the Internet for you and your doctor which allow determination of risk by answering some easy questions and inserting known lab values.

It turns out, taking a daily aspiring ONLY helps people who have greater than a 7.5% risk of having an event like a stroke or heart attack over the next 10 years.  This is considered a moderate to high risk number.  Furthermore, if you are over 70 years old and have never had a cardiovascular event or invasive procure, there is NO benefit for aspirin, even if your risk is higher.

Patients who took daily aspirin were found to have a slightly less risk of developing colon cancer, however there are far better methods to reduce the risk of colon cancer than taking aspirin (colonoscopy, stool tests) and without the bleeding risk.

The problem with aspirin is that it’s a blood thinner.  While that can be a good thing, it has been repeatedly found that aspirin can cause significant internal bleeding more often than it can prevent a first cardiovascular episode in people with lower risk (<7.5%/10years) or if they are over the age of 70.

In summary, taking aspirin for the “primary prevention” of a first cardiovascular event is often unnecessary and can result in internal bleeding without any benefit.  You and your doctor can perform a simple on-line calculation to determine your cardiovascular event risk.  If there is any question where your risk falls, then a simple low radiation chest scan looking for calcium buildup in the arteries of the heart can be recommended to further determine what medications should be added, if any.