Primary vs Secondary Prevention
| Type | Meaning | Aspirin Recommended? |
|---|---|---|
| Primary prevention | No previous heart attack or stroke | Generally NO (bleeding risk outweighs benefit) |
| Secondary prevention | Previous heart attack, stroke, or stent | YES — strongly recommended |
| Peripheral artery disease | Known narrowing of leg arteries | YES |
| High-risk surgery patients | Discuss with surgeon | Sometimes |
Important Shift in GuidelinesGuidelines changed after 2018. Aspirin for PRIMARY prevention (no prior event) is no longer routinely recommended for most people. The bleeding risk (stomach bleeds, brain bleeds) was found to outweigh the modest benefit in people who haven't already had a heart attack.
How to Take Aspirin Safely
- Take with food or milk to reduce stomach irritation
- Enteric-coated (EC) tablets are gentler on the stomach
- Never take aspirin with ibuprofen — ibuprofen blocks aspirin's antiplatelet effect
- Tell your dentist and all doctors you take daily aspirin
Stomach ProtectionIf you take daily aspirin, adding a PPI (such as omeprazole 20 mg) reduces bleeding risk by 80%. Ask your doctor whether you should take both.
Can I stop aspirin if I don't want to take it?
If you're on aspirin for secondary prevention (after a heart attack or stroke), stopping it significantly increases your risk of another event. Never stop without discussing with your doctor.
Does aspirin prevent cancer?
There is evidence aspirin reduces colorectal cancer risk with long-term use, but cancer prevention is not currently a standard indication — the bleeding risk must be balanced.
Which aspirin dose is best?
75–100 mg daily is the standard antiplatelet dose. Higher doses do not provide more benefit but cause more bleeding. In the US, 81 mg (baby aspirin) is most commonly used.
Medical Disclaimer: This page is for general education only and does not replace professional medical advice. Always consult a qualified healthcare provider.