Who Should Be Taking An Aspirin?

Who Should Be Taking An Aspirin?

Now, a new med analysis of 9 placebo control styles in the Archives of Internal Medicine have published data collected from 100,000 people over 6 years showing that we have to treat 120 people with an aspirin per day to prevent just one nonfatal heart attack. The researchers did report that total cardiovascular events decreased by 10%, but at the same time they saw a 30% increased risk for “trivial bleeding events”. Because it took treating just 73 people to trigger the bleeding event, we must think twice about an overzealous use of aspirin.


I do not recommend an aspirin for primary prevention. While an aspirin a day prevents blood clots, the final step that triggers a heart attack, it does not change atherosclerotic plaque, which is the underlying cause of heart disease. A far better way to prevent a heart attack is by keeping plaques from forming in the first place. This means, back to basics, a healthy diet, exercise, weight reduction, nutritional support with antioxidants, anti-inflammatories, blood pressure lowering, stress reduction, and so on.

But, taking an aspirin a day for secondary prevention if you already had a heart attack or have a history of cardiovascular disease, is just plain good medicine. I regularly advocate aspirin for those with known heart disease such as a history of angina, heart attack, angioplasty or stent procedures, or coronary artery bypass surgery. In these cases I recommend taking one aspirin a day.

But Will the Aspirin Work for You?

Does a patient need to take a low-dose of 81-mg or a full dose of 325-mg? The confusion comes out of research showing that not all patients respond to aspirin in the same way. In fact, some patients do not respond to aspirin at all. They are called “aspirin resistant”.

These challenges may now be overcome with a new test called Aspirin Marks, which I perform in my office. A simple urine test can show your doctor whether aspirin therapy is effective for you, as well as what dose you need. The test measures the levels of thromboxane metabolites in your system. If your test results show a low level of metabolites, it means your prescribed aspirin therapy is working. If your results are higher up the scale, you would likely benefit from increasing your dose.

If your results are very high, however, and you have already taken the maximum dose of aspirin, you are probably aspirin resistant.

In this case, it is better to stop the aspirin and not risk the gastrointestinal side effects. As always, I encourage you to follow the Pan-Asian Modified Mediterranean Diet, exercise regularly, reduce stress, and take your nutrients, and detoxification. You can keep your blood thin by natural blood thinners such as lumbrokinase or nattokinase.

Best in health,

Dean Silver, M.D.