Question:

Should I take a baby aspirin to prevent heart attack or stroke?

Answer from cardiovascular specialist John Higgins, MD:

Cardiovascular disease is the No. 1 killer worldwide. But a daily baby aspirin for prevention is complicated. I strongly encourage you to speak with your doctor, since the recommendation varies on a case-by-case basis.

For some people, a daily aspirin will do more harm than good. For example, aspirin use in some people increases their risk of bleeding. Do not take a daily baby aspirin if you have an increased risk of bleeding. Recent research found three groups of people should avoid a daily aspirin.

For these people, the risks outweigh the benefits.

Avoid daily aspirin if you're older, have an increased risk of bleeding or are at low to intermediate risk without talking to your doctor

A daily aspirin is not more beneficial for:

• Adults 70 years or older
• People with diabetes
• Intermediate risk patients (people with 10% to 19% risk of atherosclerotic cardiovascular disease (ASCVD) in the next 10 years)

Take daily aspirin if you have a history of stroke, heart attack or prior heart procedures

Aspirin should still be used to prevent cardiovascular events in certain individuals. Your doctor will likely recommend a daily aspirin if you have one of these conditions:

• Prior heart attack or myocardial infarction (MI)
• Prior stroke
• Prior percutaneous coronary intervention (PCI)
• Prior bypass surgery
• Prosthetic valves
• Other structural cardiac interventions, including stents

Ask your doctor if you're not sure

How do you know if you should ask your doctor about taking a baby aspirin? A daily aspirin may benefit people who meet all these conditions:

• 20% risk or higher of atherosclerotic cardiovascular disease (ASCVD) in the next 10 years or with significant accumulation of heart artery plaque
• No increased risk of bleeding
• Willing to take low-dose or baby aspirin daily