September 01, 2021

Should I be taking aspirin everyday if I've had a heart attack?

Q: If I've had a heart attack, should I be taking aspirin every day to help prevent more attacks? What about my wife, who has never had a heart attack — should she also take daily aspirin?

A: It's true that daily aspirin therapy may decrease the risk of heart attack and strokes in some people, but not everybody should take it. It's important to talk to your doctor before starting daily aspirin therapy, as it's not as widely recommended as in the past. Possible side effects include internal bleeding and kidney damage.

If you have experienced a heart attack or a stroke caused by a blocked artery, it's more likely your doctor will recommend that you take a daily aspirin unless you have serious adverse reactions to aspirin or a history of bleeding.

As for your wife and others without a history of stroke or heart attack, it depends. Guidelines about who should start daily aspirin therapy can be controversial and differ among organizations. A health care provider can help weigh the risks and benefits of aspirin therapy and may recommend daily aspirin for:

  • People with a history of coronary artery stenting or coronary bypass surgery
  • People at high risk of a heart attack or cardiovascular disease.
  • Certain people with diabetes and a heart disease risk factor — such as smoking or high blood pressure.
  • Certain people at risk of artery-blocking clots or with a history of blood clots.
  • People with blockages in other arteries — such as in the legs (peripheral artery disease) or in the neck (carotid artery disease). These blockages are believed to be caused by hardening of the arteries.