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Answers About Aspirin

Person pouring aspirin into hand

One third of Americans over the age of 65 take an aspirin every day. They do it to protect their heart health and reduce their risk of heart attack and stroke in line with conventional wisdom that has been around for years. However, according to new research, most of them don't need it - and some of them could be putting themselves at risk for health complications.

Aspirin is what is known as an anti-platelet agent. Platelets are the substance in your blood that causes it to clot. While those clots are great when you get a cut, they can cause problems when they form in your blood stream. "Platelets clumping and forming clots can lead to heart attacks and stroke," said John Ryan, MD, a cardiologist with University of Utah Health. "So, the thought has been that if you can decrease those clots you can reduce your risk."

The problem comes when those clots don't form in other situations. If a bleed starts and needs to be stopped, the lack of clotting can be life threatening. As older people are more at risk for external bleeds due to increased fall risks, fragile or thin skin, and other common complications of aging, this is a real concern. "The risk of internal bleeding is also very real," said Ryan. "A severe gastrointestinal bleed or a hemorrhagic stroke could be fatal."

This isn't to say that aspirin should be avoided altogether. It is still a good painkiller and anti-inflammatory medication. If you have pain or a fever that needs to be reduced you shouldn't fear taking it. It can even be used to soothe bug bite and stings. "The risk comes with prolonged use," said Ryan. "Two aspirin for a headache or tooth pain isn't going to lead to serious clotting issues."

There are some for whom a daily aspirin could still be beneficial: those who have previously had a heart attack or stroke, and those who have conditions that put them at a higher risk for heart attack and stroke, like people with diabetes, or high blood pressure. "Only if you truly have risk factors should you consider an aspirin regimen," said Ryan. "If you are unsure it's best to talk to your doctor first."