The new guidelines on aspirin intake have created fair amount of confusion among our patients and the general population at large.

First of all, I want to be sure to tell anyone who is currently taking aspirin at the recommendation of their doctor NOT to stop the aspirin. Let us be clear on this issue, if you already have history of coronary artery disease you must continue to take your aspirin without interruption and if in doubt, be sure to discuss it with your doctor. Any one who has history of a heart attack or a coronary stent or has had bypass surgery and all those patients who have a history of non-obstructive atherosclerotic disease must continue to take their aspirin as prescribed. In addition all patients who have had a stroke or a mini stroke ( TIA) and have been taking an aspirin should remain on their current regimen.

What is important to understand is that there are two kinds of prevention (primary and secondary prevention). Secondary prevention refers to preventing recurrence of disease. For example if you have ever suffered a mini stroke ( TIA) , you would be prescribed an aspirin to prevent future recurrence of a stroke.

Primary prevention refers to initiation of measures including taking medications that would prevent the disease in the first place. The new American Heart Association guidelines recommend against the intake of aspirin in older patients ( over the age of 70) who have never taken aspirin and want to start now. In that population, the risks of aspirin outweigh the benefits.

In summary, if you are taking aspirin, do not stop until you discuss with your doctor and if you have never taken aspirin do not start it until you discuss it with your doctor.