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Can an Aspirin a Day Do More Harm Than Good?

Experts are re-evaluating who should take a daily dose

The traditional point of view, LeFevre says, was: “Aspirin is a pretty benign thing. Why doesn’t everybody take one? Aspirin, as it turns out, is not harmless.”

Strokes vs. heart attacks

Many of the risk factors for heart attacks and strokes — including age, diabetes and smoking — overlap, but there are slight differences. High total cholesterol and high levels of LDL or “bad” cholesterol, for instance, are important predictors of heart attacks.

The most important risk factors for strokes include high blood pressure, certain kinds of irregular heartbeats (known as atrial fibrillation) and a condition known as left ventricular hypertrophy in which some of the heart muscle thickens.

Experts agree that women who have already had strokes and men who have already had heart attacks should absolutely be taking aspirin. “You have to make sure that people with a history of heart attack or stroke do not stop their aspirin, because it could be a deadly mistake,” says NYU’s Berger.

Clearly, the benefits of aspirin have to be weighed against the possibility of bleeding, and that’s a conversation that experts say every patient needs to have with his or her doctor.

“This decision has to be made one person at a time,” LeFevre says. “There is no one blanket recommendation for everybody.”

Emily Anthes writes about health and science and lives in Brooklyn.

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