By Staff

Aspirin is often hailed as a wonder drug, thanks to its ability to help stave off heart attacks and clot-caused strokes. But fewer than half of people who could benefit from a daily low-dose aspirin take it, while many others take it when they shouldn't.

If you don't have heart disease, but do have high blood pressure, diabetes, or other risk factors for heart disease, don't automatically assume that taking aspirin every day is a good idea. "A lot of people take aspirin who really shouldn't," says Dr. Christopher Cannon, a cardiologist at Brigham and Women's Hospital and professor of medicine at Harvard Medical School. "Everyone assumes aspirin is harmless, but it isn't." For some, the downsides of aspirin—mainly gastrointestinal bleeding—outweigh its benefits.

Aspirin makes blood platelets less "sticky," and so less like to clump in the bloodstream, an early stage of blood clot formation. Most heart attacks happen when a clot blocks blood flow in a vessel that feeds the heart. Dampening the clot-forming process lowers the odds of a blockage.

At the same time, aspirin inhibits the formation of substances that protect the stomach's delicate lining. As a result, stomach upset or bleeding in the stomach and intestines can occur. Anyone taking daily low-dose aspirin who notices stomach irritation or upset should call his or her doctor, urges Dr. Cannon.

Taking aspirin with food may help. So can taking medications to treat heartburn, which help protect the stomach. These include simple antacids like Tums, acid blockers like famotidine (generic, Pepcid, Fluxid), or proton-pump inhibitors such as omeprazole (generic, Prilosec, Zegerid). A pill that combines aspirin and omeprazole may soon be available.

Before starting daily aspirin therapy, it's best to consult with a trusted doctor to weigh the risks and benefits. In addition to heart disease risk, important considerations include other health conditions, other medications taken, and even weight.