Is aspirin necessary to treat heart disease?

A fellow caregiver asked...

My father was recently diagnosed with coronary heart disease. Should he be taking a daily dose of aspirin?

Expert Answer

Barry M. Massie is chief of cardiology at the San Francisco V.A. Medical Center.

Yes. Aspirin may prevent blood clots from forming in the arteries of the heart, the primary cause of heart attacks in patients with coronary heart disease. I recommend taking a baby aspirin (81 mg) -- higher doses aren't more effective and cause more side effects such as bleeding.

However, taking aspirin is just one of the ways your father can reduce his risk of having a heart attack or stroke. Most people with coronary heart disease also need a cholesterol-lowering medication (a statin), but that depends on the lipid levels in his blood. You and your father may want to discuss this with his physician.

If your father smokes, he needs to stop, and his systolic blood pressure (the top number) should be brought below 140 mm Hg (or below 130 if he's diabetic). Medications that lower blood pressure and may also prevent complications of coronary disease include angiotensin converting enzyme (ACE) inhibitors and, especially if he has had a heart attack, beta-blockers.

Many studies have shown that fully implementing these preventative approaches -- in addition to a healthy diet, weight loss in overweight patients, and moderate exercise -- can greatly reduce the risk of heart attacks and strokes in people with coronary heart disease.