The recommendation that certain people take a daily low dose of aspirin to prevent a heart attack has been around for a while now. But it’s still not entirely clear which people would benefit the most — or at all — from taking a daily aspirin and which may get no significant benefit.
The American Diabetes Association (ADA) currently recommends a daily low dose of aspirin (75–162 milligrams) for the following groups:
- People with diabetes who have already had a heart attack or stroke or who have been diagnosed with some form of cardiovascular disease (such as atherosclerosis or peripheral arterial disease)
- People with diabetes (Type 1 or Type 2) who are at increased risk of developing cardiovascular disease because they are over 40, have a family history of heart disease, smoke, have high blood pressure or a blood lipid (cholesterol and triglyceride) disorder, or have albuminuria (protein in the urine). (Click here to learn about risk factors for heart disease.)
The ADA makes these recommendations because people with diabetes generally have a risk for cardiovascular disease that is two to four times greater than that of the rest of the American population. In addition, people with diabetes tend to have increased “platelet aggregation,” which means that their blood is more likely to clot abnormally, which can lead to a heart attack or stroke. Aspirin decreases blood clot formation, therefore lowering these risks.
In all cases, however, a person should talk to his doctor before starting to take daily aspirin. Having certain medical conditions (besides diabetes) and/or taking certain medicines that interfere or interact with aspirin may make it unsafe for some individuals.
Aspirin belongs to the class of drugs known as nonsteroidal anti-inflammatory drugs, or NSAIDs. It is commonly used to relieve mild to moderate aches and pains, such as headache or sore throat, and to reduce fever.
Aspirin is sold over the counter as a generic product and under many brand names in a number of forms: tablets, caplets, gelcaps, chewable tablets, suppositories, enteric-coated tablets (which have a barrier applied to the outer surface that prevents the release of the drug until it reaches the small intestine), and buffered tablets (which contain ingredients to reduce stomach acid). (To learn about some commonly used low-dose aspirin products, click here.) Aspirin is also an ingredient in some combination medicines. The dose of aspirin per tablet, caplet, etc., can range from 75 milligrams (mg) to 650 mg.
Because the most common side effect of routine aspirin use is irritation of the stomach lining, some physicians prefer enteric-coated or buffered aspirin for daily aspirin therapy. Taking aspirin with food, milk, or a full glass of water can also help minimize stomach irritation.
When taking aspirin on a daily basis, it is generally best to take it at the same time each day. Avoid taking it with other NSAIDs, such as ibuprofen (brand name Advil and others), naproxen (Aleve, Naprosyn), and diclofenac (Voltaren); doing so may make one or both of the drugs less effective or increase the risk of side effects. If you must take both aspirin and ibuprofen, either take ibuprofen 8 hours before aspirin or 30 minutes after non-enteric-coated aspirin. The NSAID celecoxib (Celebrex) can be used at the same time as low-dose aspirin, but doing so increases the risk of gastrointestinal bleeding.