Should You Be Taking An Aspirin A Day?

Patient Expert

Menopause brings on so many changes that it's hard to know what to do first. Address your hot flashes? Take care of your mood swings? What about those headaches?

Actually, while menopause brings on a lot of physical changes, many of which can be annoying, your biggest concern as you reach menopause and move beyond it, is your heart. Heart disease is the number one killer of post-menopausal women. According to an article by Dr. Wen Shen, assistant professor, division of gynecologic specialties at Johns Hopkins University School of Medicine, the median duration of menopausal symptoms is four years.   If you think that sounds like along time, think how quickly the time flew by when your children were in first to fourth grade.   Really, the symptoms don't last forever.

However, the effects of "getting older" on your heart do last forever, and add to that a lifetime of (maybe) eating the wrong things, not getting enough exercise, plus perhaps some inherited traits like diabetes, and your heart needs your attention NOW.

Your heart is easy to ignore. After all, it's hidden inside you, it beats every day, everything must be fine, right? Not so fast. Believe me, I have seen the effects of ignoring your heart and your entire circulatory system and they are not pretty.   When I'm working as an EMT, if a woman (or her family) calls 911 and she is over 45 and she doesn't feel well, we are trained to think "heart attack" (what we call cardiac arrest or MI for myocardial infarction, a heart attack in progress).  It's   a very common emergency call-middle aged or older woman, maybe a bit overweight, maybe her ankles are a little swollen, maybe she has diabetes, difficulty breathing, and pain somewhere, not always in her chest. The results of this scenario are usually not very pleasant. I want to say to the woman, "What were you thinking? Didn't you KNOW that losing weight and exercise were critical to your heart health?"

Another critical piece of taking care of your heart may be taking an aspirin regularly. In the Women's Health Study reported in 2005, almost 40,000 women over 45 were studied for 10 years, and the benefits of taking low-dose aspirin (100 mg every other day) became clear for women over 65. There was a 26% reduction in risk for major cardiovascular events, including stroke (a blot clot that travels to the brain, blocking blood flow). For women between 45 and 65, there was no significant reduction in the risk of death from having a first heart attack; however, it showed a reduction in the risk of a stroke.

Aspirin is not a harmless drug and should not be taken without consulting your health care provider. Aspirin keeps the platelets in your blood from sticking together;  that's what makes it work in helping to prevent heart attacks and strokes. But those platelets are very important in the blood clotting process, so if you have risk factors that would make aspirin a bad choice for you, such as the risk of gastrointestinal bleeding, then that should be considered.

Several studies have indicated that aspirin therapy for women who have already had a cardiovascular "event" such as a heart attack is a good idea, but chances are if you have already had a heart attack, you are under a doctor's care. If you are over 65, you may benefit from a low-dose aspirin, such as a baby aspirin, daily. If you have diabetes or a history of heart disease in your family, you may benefit from an aspirin a day even if you are under 65, but the Women's Health Study didn't take that into consideration. Other studies have, and the American Heart Association recommends it for women with diabetes. But again, talk to your physician.

And take care of your heart.  I don't want to see you in the back of my ambulance someday.