Low-Dose Aspirin to Prevent a Heart Attack – a Good Strategy?

By Stephen T. Sinatra, M.D., F.A.C.C., F.A.C.N., C.N.S., C.B.T.

Many people take aspirin on a daily basis as a preventive strategy against cardiovascular disease. Is it effective, and if so, what about low-dose aspirin?

The answer is that it depends on what you mean by prevention. If you mean primary prevention, that is, to prevent a first heart attack or stroke down the line, the answer is no.

And the same answer – no – applies to both full-strength aspirin (325 milligrams) and the low-dose version (81-100 milligrams).

There’s no evidence that either is an effective or safe option for primary prevention, or that with low-dose aspirin you can altogether avoid the risk of adverse gastrointestinal effects – such as abdominal pain, heartburn, ulcers, and bleeding − associated with regular full-strength aspirin.

A 2014 study published in the Journal of the American Medical Association reported on the results of a large investigation among more than 14,000 Japanese patients over the age of 60 with some kind of a definite risk factor for heart attack or stroke such as hypertension or diabetes.

These at-risk patients were randomly divided to take either a low-dose aspirin (100 milligrams) once daily or an inert placebo. They were followed for about five years. The results failed to show any significant reduction in cardiovascular deaths, and non-fatal heart attacks or strokes. The patients on the low-dose aspirin experienced almost double the gastrointestinal side effects as those taking the placebo.

The current recommendation from the American Heart Association is that low-dose is the aspirin of choice AFTER an initial cardiovascular event or for someone with diagnosed heart disease. However, many doctors are prescribing regular dose aspirin, and that’s a potential problem because of the known side effects, and especially since studies show low-dose is just as effective and safer for that purpose.

To learn more about the use of aspirin for prevention, take a look at my video and article here.


© 2015 HeartMD Institute. All rights reserved.

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  1. Baldev Pal

    on July 2, 2015 at 4:42 pm

    Health news is useful and informative.

  2. Martha Dancy

    on July 2, 2015 at 4:49 pm

    I take 2 anacin a day with juice and chewing up the anacin so it does not sit in the stomach in a lump. I use it not for heart so much as for arthritis pain. The other pain relievers are more dangerous than aspirin because they cause liver damage and/or worse heart disease so I avoid them. That leaves me only one safer alternative, and that is the aspirin version with caffeine which is anacin. It has worked well for my arthritis and though it cause mild tinnitus, I still feel that there is no other thing, even the herbs I take that is strong enough to control my arthritis without worse side effects.

  3. Diane

    on July 2, 2015 at 5:23 pm

    My father had a heart attack in 1983. A few years later his doctor/internist (who I will credit with saving his life when he had the heart attack) got on the aspirin bandwagon & recommended Dad take an aspirin a day. We told the doctor my Dad had a long history of stomach ulcers. The doctor then suggested he take a baby aspirin daily. A few months later my father passed out in the kitchen & had to be taken to the hospital by ambulance. It turned out the aspirin had caused a severe bleed in his stomach & they pumped 5 pints of blood into him to save his life. End of aspiring for him.

  4. Mark Littlewood

    on July 2, 2015 at 5:44 pm

    How about taking Fruitflow or maybe Nattokinase as an alternative to aspirin ?

  5. willy

    on July 2, 2015 at 6:01 pm

    Dr Sinatra, but does Dr. Barry Sears position still hold true – trace amounts of aspirin (20/40mg) with fish oil are a great way to combat macro-phages to prevent stroke?


  6. meena

    on July 2, 2015 at 7:38 pm

    Sir what is alternate to aspirin?

  7. Mark Littlewood

    on July 2, 2015 at 9:44 pm

    Check Fruitflow also Nattokinase

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