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New recommendations about daily Aspirin

Cardiologists have long lauded the benefits of baby aspirin for the prevention of heart attacks and strokes. But that old adage is changing as taking aspirin is not without risk. Taking a baby aspirin has been found to reduce the risk of heart attack and ischemic stroke (i.e. those caused by clots in the brain). However, aspirin also significantly increase your risk of major bleeding including GI bleeding and hemorrhagic strokes. Therefore, in patients without known coronary vascular disease or cerebrovascular disease, the risks and benefits of aspirin need to be carefully discussed with your cardiologist.

Most people with known coronary artery disease, those with stents, or those who have had bypass surgery or prior ischemic stroke should be on a baby aspirin prescribed by a doctor. In this case, the aspirin is for ‘secondary prevention” – i.e. an adverse cardiac event has already occurred and we are trying to prevent the next one.

For those without known coronary artery disease (CAD) or cerebrovascular disease (CVD), using aspirin for primary prevention (i.e. to prevent a heart attack or stroke) needs to be carefully considered. If you have a lot of risk factors for CAD/CVD and your ASCVD risk score is >7.5% or you have a calcium score > 1, starting a baby aspirin would be recommended if your risk of bleeding is low.

Bottom line, aspirin isn’t for everyone. Come talk to us about your cardiovascular risk and whether starting or continuing on aspirin is right for you.

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Dr. Bennet is board-certified in cardiology. She is among the top rated cardiologists in the area and sees patients with all cardiac conditions. Dr. Bennet received her medical degree from Johns Hopkins School of Medicine and completed her residency training in internal medicine at the Massachusetts General Hospital in Boston. She has published multiple peer reviewed articles and presented at national meetings on topics in international cardiology and quality improvement in cardiovascular care delivery. She is an active member and fellow of the American College of Cardiology (ACC) and is on the board of the Maryland Chapter of the ACC.

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