An aspirin a day … is it right for you?

Clearing the air on who benefits from a daily aspirin

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If you’ve had a heart attack, you should be taking a low-dose aspirin a day.

Aspirin is truly a wonder drug when it comes to coronary artery disease (CAD). But what about the Food and Drug Administration’s recently released statement saying an aspirin a day is only for a select few?

In medicine, we define our treatments for CAD as primary and secondary prevention measures.

Primary prevention

Patients who have never had a heart attack or do not have any formal diagnosis of CAD fall into what we refer to as the primary prevention group. In this group, we commonly further subdivide patients into low and high risk for developing CAD. The more risk factors a patient has (family history, diabetes, hypertension, high cholesterol), the higher his or her lifetime risk is for having a heart attack. Patients older than 50 who are at high risk for developing CAD might benefit from taking 81 mg of aspirin every morning.

Secondary prevention

Patients who have already had a heart attack or have been diagnosed with CAD fall into the secondary prevention category. In this group, our goal is to prevent a second cardiac event. Ideally, everyone in this group should be taking an aspirin a day. The current recommended dose is one or two baby aspirin (81 or 162 mg every morning). A higher aspirin dose (325 mg) doesn’t necessarily reduce the risk of another heart attack, but instead potentially increases a patient’s bleeding risk.

No “one size fits all”

It is difficult to come up with a blanket statement for all patients with respect to aspirin, as it also depends on a patient’s bleeding risk as well as other factors. If a patient has had a heart attack (and there are no contraindications for using aspirin), I encourage him or her to take 81 mg of aspirin every morning.

For the primary prevention group of patients (if there is no increased risk associated with taking aspirin, the patient has multiple cardiac risk factors and is age 50 or older), I prescribe 81 mg of aspirin every morning.

For all patients, I encourage you to discuss aspirin use with your doctor before starting. Finally, aspirin should be taken after breakfast to decrease stomach irritation.

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tobin_kenneth 150x150Dr. Kenneth Tobin is a clinical assistant professor for the Department of Internal Medicine and director in the Chest Pain Center at the University of Michigan. His specialty is cardiology, with clinical interests in the association of patent foramen ovale and stroke, patent foramen ovale and migraine, preventive cardiology and echocardiography.



Frankel-informal-vertical-sigThe University of Michigan Samuel and Jean Frankel Cardiovascular Center is the top-ranked heart and heart surgery program among Michigan hospitals. To learn more, visit our website at







Men’s heart health tips

Develop good habits early for a healthy heart later in life

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Adopting healthy habits at a young age can pay off as you age.

As we age, the stakes get higher for coronary artery disease (CAD). A man in his 70s has a higher risk of developing CAD than a man in his 20s. But CAD does not occur overnight.

Even at 20 years old, you can affect what happens to you and your heart health when you are older. Having an appropriate health maintenance exam to define your risk of diabetes, high cholesterol levels, high blood pressure and other cardiac risk factors is very important for heart health.

The role genetics plays

The single biggest risk factor for developing CAD is genetics. A person (man or woman) who has a family history of early-age CAD (usually defined as 55 or younger) needs to be extremely diligent about his or her heart health.

Even though you can’t change genetics, there are certain genetic risk factors that can be modified — and the earlier you start, the better. Continue reading