If you’re still going by the adage of “an aspirin a day keeps the heart doc away,” we have news for you: It may not be that straightforward anymore.
For decades, some doctors have recommended that their patients at high risk of a first heart attack or stroke take a low-dose of aspirin daily as a main form of prevention. But in a new commentary, researchers are raising some eyebrows at these guidelines and saying, “Not so fast.”
In the commentary recently published in the American Journal of Medicine, researchers say these guidelines shouldn’t be taken at face value. The best option for doctors, they argue, is to decide if and how to prescribe aspirin for heart disease prevention on a patient-by-patient basis. Basically, your doc should weigh the risks and benefits based on your personal health history and risk factors for heart disease—and use that information to decide whether to prescribe preventive aspirin.
“In primary prevention [of cardiovascular disease], the balance of absolute benefits, which are lower than in secondary prevention patients, and risks of aspirin, which are the same as in secondary prevention, is far less clear,” said study author Charles H. Hennekens, M.D., senior academic advisor in Florida Atlantic University's Schmidt College of Medicine, in a news release.
For other patients, Dr. Hennekens said, the benefits of aspirin are more blatant.
"All patients suffering from an acute heart attack should receive 325 mg of regular aspirin promptly, and daily thereafter, to reduce their death rate as well as subsequent risks of heart attacks and strokes," he explained. "In addition, among long-term survivors of prior heart attacks or occlusive strokes, aspirin should be prescribed long-term unless there is a specific contraindication.”
Moral of the story? Talk with your doctor about aspirin use for heart disease prevention and whether it makes sense for your body and your health.
"General guidelines for aspirin in primary prevention do not seem to be justified," said Dr. Hennekens. "As is generally the case, the primary care provider has the most complete information about the benefits and risks for each of his or her patients."
Your Risk of Heart Disease
Beyond aspirin, there are other steps—some of them with even more evidence backing them—you can take to lower your risk of cardiovascular events like heart attack and stroke. Here are some heart-healthy habits to adopt, per the National Institute of Health:
Watch that blood pressure. High BP seriously ups your risk of heart disease, so make sure you’re monitoring yours. Your doc should be checking your blood pressure at your yearly checkups. If your BP is high, they can recommend tips to help bring it down.
Eat a heart-healthy diet. The foods you eat can help reduce your risk of heart attack and stroke. Go for a diet with limited added sugars, saturated fats, and high-sodium foods. Instead, fill your plate with fresh fruit and veggies and whole grains.
Get regular physical activity. Not only does movement make us feel good, but it’s good for your heart health, too. Exercising literally strengthens your heart and improves the health of your overall circulatory system, lowering your heart attack and stroke risk.
Manage cholesterol and triglyceride levels. If your cholesterol is high, your arteries can get clogged—and that’s when your risk of heart disease increases. Certain lifestyle changes (again, diet and exercise) along with medications in some cases can help reduce your cholesterol and triglyceride levels.
Manage your diabetes. If you have diabetes, your risk of heart disease is even greater. Make sure your doctor is testing you for diabetes regularly. If you’re already diagnosed, follow your doctor’s orders to make sure you’re managing it properly.
Limit your alcohol consumption. Too much booze can up your blood pressure, and your weight, which can make you more likely to develop heart disease. For men, guidelines say to stick to two drinks or fewer daily. For women, it’s one drink or fewer.
Say no to smoking. Smoking cigarettes also raises your blood pressure and your risk for heart disease. If you’re not a smoker, don’t start. If you do smoke, take steps to quit ASAP.
Get your stress under control. Stress is linked with heart disease, so it’s important to take steps to cope with stress in healthy ways. That might mean practicing mindfulness like meditation or yoga, listening to music you find calming, or getting in that regular exercise to chill out.
- Catch some Zzs. It’s no secret that sleep is key for your health, and that goes for your heart health, too. Aim for 7-9 hours a night and practice good sleep hygiene to make sure those hours are high-quality.