Is aspirin always good for the heart?

Dani Meager, Nelson Liu and Western RadiologySponsored
Aspirin can be important if you have heart disease, but what about in healthy individuals?
Camera IconAspirin can be important if you have heart disease, but what about in healthy individuals? Credit: Getty Images/iStockphoto

Tackling cardiovascular risk with aspirin is a popular option because it is almost always prescribed to those who already have heart disease, but what about in healthy individuals?

When plaque in the artery walls becomes inflamed, your body attempts to contain the damage by forming a blood clot. However, a clot can further obstruct an already constricted blood vessel and stop the circulation of blood to the brain or heart, causing a heart attack or stroke.

A low dose of aspirin is typically prescribed for people who have had heart attacks or strokes but is sometimes also prescribed for those at risk of cardiovascular disease.

How does aspirin help?

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In addition to relieving pain, lowering fever and reducing inflammation, aspirin prevents blood clots from forming by hindering the ability of your platelets (the smallest blood cells) to clump together.

According to Western Radiology cardiologist Adil Rajwani, aspirin is almost always recommended if you have a history of cardiovascular disease, but the jury is still out for those who have not had a heart attack but are thought to be at future risk of one. While aspirin’s ‘blood thinning’ quality can prevent heart attacks and strokes, it is important to be aware of some of the risks.

Are there any complications of aspirin use?

Dr Rajwani said recent studies have confirmed that while aspirin may potentially lower the risk of future of heart attacks and strokes in those who are at risk but have not actually had a heart attack, the trade-off is that bleeding can be a complication.

“Most ‘bleeding’ is just nuisance bleeding of no major consequence,” he said. “However, a small proportion will have more significant and dangerous internal bleeding.

“The studies suggest that the overall benefit of fewer heart attacks is offset by the small but serious occurrence of major internal bleeding, meaning no overall net benefit - and in the case of the elderly, maybe even a trend towards harm.”

However, most people recruited to the three studies were only at low or moderate cardiovascular risk, and some doctors continue to speculate that the scales might still be tipped in favour of aspirin if the patient is at high cardiovascular risk.

When should you consult your doctor?

With growing interest in personalised treatments, doctors are now shifting from routinely prescribing aspirin as a preventative measure to only doing so in carefully selected individuals. How? Recent studies suggest that medical imaging tests that can visualise the overall amount of plaque in the coronary arteries could be an important tool to more accurately determine cardiovascular risk.

“Further individualising the assessment with a CT coronary artery calcium score can provide incremental information in the specific individual,” Dr Rajwani said.

“Personalised tests could help determine which patients have the most plaque – and thus stand to gain the most from aspirin as a preventative measure. Alternatively, in those with little or no plaque, this may prompt the cessation of an existing aspirin prescription”.

Dr Rajwani said people must always consult their doctor first before either starting or stopping aspirin, who will also integrate other clinical tools to assist with assessments, and those who have already developed angina, heart attacks or strokes should never stop their medications without medical input.

Dr Rajwani also reflected upon the importance of not to neglecting the power of a healthy lifestyle.

“Diet, exercise, weight loss, smoking cessation, controlling blood pressure and cholesterol are the bedrock of good heart health,” he said.

Western Radiology delivers advanced diagnostic imaging and interventions, with a focus on high-quality imaging and excellent service. Visit the website to find out more.

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