What is aspirin?
Aspirin is a blood-thinning medication that stops blood clots from forming by preventing small blood cells (platelets) from sticking to each other. It is the most widely used medication to prevent heart attack and stroke.
|Generic name:||aspirin (acetylsalicylic acid)|
|Brand name:||Bayer, St. Joseph, Ecotrin|
|How it is given:||Pill (the most common daily doses are 81 mg [baby aspirin] and 325 mg)|
|What it is used for:|
|You should not be treated with it if:||
|Pregnancy/nursing:||You should not take aspirin in the last 3 months of pregnancy unless recommended by your doctor.1 Aspirin is found in breast milk, so discuss breastfeeding with your doctor ahead of time if you are taking or planning to start a daily aspirin regimen.|
Who should take aspirin to treat PAD?
Most women with PAD or carotid artery disease should take daily aspirin to reduce the risk of heart attack, stroke, and dying of heart or blood vessel disease.2,3 Women who have a had a procedure to treat artery disease, such as peripheral artery bypass surgery, angioplasty and stents, or carotid endarterectomy, should take aspirin for the rest of their lives to prevent to prevent blood clots.3,4
The benefits of aspirin are not as clear in women who have been diagnosed with PAD using an ankle-brachial index test, but do not have symptoms of PAD and do not have other forms of artery disease or risk factors for heart attack and stroke.5
Who should not take aspirin?
While many women benefit from taking daily aspirin to prevent heart attack and stroke, for women with certain conditions the risk of bleeding outweighs the benefits. Women who have recently had a bleeding stroke or who are currently bleeding (such as from a stomach ulcer or recent surgery) should not take aspirin. Never start an aspirin regimen without first discussing it with your doctor.
If you have had an allergic reaction to aspirin in the past, or have developed aspirin resistance (a condition in which aspirin becomes less effective at thinning the blood), ask your doctor if it is safe for you to take aspirin. You should not take daily aspirin (or most other painkillers) if you drink more than three alcoholic drinks per day. This combination increases your risk of liver damage and bleeding in the stomach.
What are the benefits of aspirin in women with PAD?
Aspirin can prevent heart attack, stroke, and dying of heart or blood vessel disease in women at risk, including women with PAD. The use of daily aspirin in women who do not have PAD symptoms is controversial.
A large analysis of blood-thinning drugs (mostly aspirin) in 9,716 high-risk patients with PAD found that these medications reduced heart risk. The chance of having a heart attack, stroke, or dying of heart or blood vessel disease was lowered by 23% in patients with leg pain during exercise ( intermittent claudication), 22% in patients who had peripheral artery bypass surgery, and 29% who had an angioplasty and stent procedure to treat PAD.6 The benefits were similar in women and men. Another study of 2,420 patients with PAD (28% were women) found aspirin reduced the risk of dying by 28% over an 8-year period.7
Although aspirin can prevent serious complications in women with PAD who are at high risk for heart attack and stroke, the benefits are less clear in women who do not have PAD symptoms. A trial of 3,350 patients (72% were women) with PAD based on an ankle-brachial index test but without PAD symptoms found that daily aspirin did not prevent heart attack, stroke, or worsening PAD compared with placebo (sugar pill).5 Neither women nor men showed a benefit of aspirin in this study. Other trials have had similar results.8
Current guidelines recommend that all women with PAD receive daily aspirin to prevent heart attack, stroke, and dying of heart or blood vessel disease.2 However, given the results of recent studies, you may want to discuss the risks and benefits of daily aspirin with your doctor if you have PAD but do not have any symptoms or other high-risk conditions.
What is the best dose of aspirin?
In women with PAD, guidelines recommend daily aspirin doses between 75 mg and 100 mg.2,3 In the US, most doctors prescribe 81 mg a day (baby aspirin).9 Higher doses are no more effective at preventing heart disease and stroke but are more likely to cause stomach problems and bleeding side effects.6,10 You should work with your doctor to determine the aspirin dose that is best suited to you.
What are the possible side effects of aspirin?
Because aspirin interferes with the blood's ability to clot, the most serious side effect of regular aspirin use is bleeding in the stomach, which is more common in people older than 70 years. Serious bleeding is rare (less than 3% of patients taking regular aspirin), but is 40% more likely to occur in women.11 Tell your doctor immediately if you experience unusual bruising or bleeding, such as nosebleeds, blood in the urine, or black or bloody stool.12
Side effects that are more common include upset stomach and nausea. Enteric-coated or buffered aspirin may be easier on your stomach, but there is no evidence it is safer.
Although rare, some women are allergic to aspirin. Seek emergency medical attention if you experience any of these signs of an allergic reaction:
- Hives, rash, or itching
- Faintness, dizziness, or loss of consciousness
- Difficulty breathing
- Numbness or tingling
- Chest pain or pressure
If you are taking daily aspirin, you should not take naproxen (Aleve), ibuprofen (Advil, Motrin), or other NSAIDs (non-steroidal anti-inflammatory drugs). These drugs may make aspirin less effective and can increase the risk of serious side effects, including liver and kidney damage, when combined with aspirin.
Are there any alternatives to aspirin for women with PAD?
If you cannot take aspirin, another type of blood thinner called clopidogrel can also reduce the risk of heart attack, stroke, and dying of heart or blood vessel disease.2 Click "Next" to learn more.