Should or should not my father take aspirin after a stroke?

4 answers | Last updated: Oct 22, 2016
A fellow caregiver asked...

My father had a major hemorrhage stroke deep in the occipital lobe of the brain on 17 December 2010. He had been taking cartia everyday upon his GP's advice until this stroke. Upon admission to the Emergency Section of the hospital, when he was having his stroke, the hospital doctor taking care of him said taking aspirin type tablets was the wrong thing to be taking for him. Dad does not have high blood pressure, cholesterol, or any complaint at all. He is on no medication. His last CT scan 2 weeks ago showed lots of scarring and some blood. No change at all to the CT scan he had just after the major hemorrhage stroke according to the radiologist report. The doctor at the hospital said the stroke was so deep in the brain there was nothing they could do but wait to see if it stopped bleeding and if it didn't they expected dad to die. Now the same local GP he has had to return to for general care is trying to put dad back on the asprin tablet daily again. I live in a town in outback Australia where we are hours from anywhere and you can't get to a specialist or have much choice of doctors. Dad is coming along so well now, he walks again, does jobs around the house such as washing dishes, cares for himself (baths, showers, toilets, dresses himself, etc) and this is from being told he may never recover the use of movement ever. Consequently, being told to go on an asprin tablet a day has really frightened dad and he is really upset and concerned. It would be appreciated if I could have some advice regarding any medication which dad should be on for prevention, or if he should just take care of himself (rest and exercise). Your advice is much appreciated. Sandra

Expert Answers

James Castle, M.D. is a neurologist at NorthShore University HealthSystem (affiliated with The University of Chicago) and an expert on strokes.

This is a tough question, one for which there is no definite right or wrong answer. In general, if someone has had a bleeding stroke (such as your father), but has never had a heart attack or ischemic stroke (stroke caused by a clot in one of the arteries to the brain), I would say he should not be on aspirin. If he has had either of those in the past, then aspirin should be ok provided he keeps his blood pressure under extremely tight control.

Based on the description you gave, that his bleed was deep within the brain, my best guess is that this was a "hypertensive hemorrhage". In other words, likely due to a lifetime of having higher than normal blood pressure. If that is the case, far and away the most important thing to be done is to get that blood pressure under VERY tight control. As a general rule, if you add the systolic and diastolic blood pressure numbers together, the goal should be to have a total number of less than 200. If he gets lightheaded or woozy with blood pressure medicines, then this goal can be adjusted (of course, always due this with the guidance of your local physician). Blood pressure control, in his case, will be much more important than aspirin.

To summarize: If he has never had a heart attack, or other ischemic vascular event such as ischemic stroke, I would not give him aspirin. If he has had one of those, aspirin can be considered, but should be done only in conjunction with tight blood pressure control. In either case, he needs his blood pressure watched EXTREMELY CLOSELY.

I hope that helps. Good luck.

Community Answers

Adjunct prof.rosellfernandez answered...

My mother lived with a blood clot in her brain for 40 years--and the inquiry here states that her father did not have high blood pressure.

Any bleeding in arteries and pathways shows weak vascular conditions. Did he hit his head at anytime?

Please read Dr. Richard Fleming's Stop Inflammation Now! online if you cannot find it in a bookstore.

Mom broke her arm at 93-they said she would never lift her arm again.wrong. she had paralysis from the stroke on the right side and they said she would not regain movement.(at 60) wrong.

Any doctor giving you "expert" advice without seeing clinical evidence is not someone I would believe. Meanwhile where you are there are natural foods. Strengthen his body..cut the sugar, cut the salt..use the ingredients that are natural and native to your country.

A fellow caregiver answered...

According to the American Heart Association: AHA Recommendation

The American Heart Association recommends aspirin use for patients who've had a myocardial infarction (heart attack), unstable angina, ischemic stroke (caused by blood clot) or transient ischemic attacks (TIAs or "little strokes"), if not contraindicated. This recommendation is based on sound evidence from clinical trials showing that aspirin helps prevent the recurrence of such events as heart attack, hospitalization for recurrent angina, second strokes, etc. (secondary prevention). Studies show aspirin also helps prevent these events from occurring in people at high risk (primary prevention).

You should not start aspirin therapy without first consulting your physician. The risks and benefits of aspirin therapy vary for each person.

I think your best bet is to find a specialist. GPs only know so much..the specialist will be able to make the right recommendation.

My Mom had a stroke, but she is on other blood thinner medications. Aspirin thins your blood, so if you get a cut the bleeding lasts longer. Does your Dad have high blood pressure because of a blockage?

Adjunct prof.rosellfernandez answered...

Dear readers:

Please pay attention. The query from the daughter clearly states that her father DOES NOT HAVE HIGH BLOOD PRESSURE.

The American Heart Association is just that a medical organization where in they include studies from "professionals" she is in Australia.

Therefore the "American" protocol is not necessarily theirs.

Fact: People have heart attacks who do NOT have high blood pressure. Dogmas and protocols stop doctors from really listening to the patient.

Vitamin E is also a blood thinner. So any foods that contain high amounts are a better plan. Amongst many. My mother in the end was right, and I an anthropologist and researcher for 40 years on my way to law school, thought I knew more than she. wrong. She was living proof that good nutrition is the answer and you are in a better place than we are with toxic chemicals added to our water, food, and beverages for the profit motive. Read Fast Food Nation...and don't follow any advice from any magazine. Go to the source yourself. Thank you.