Harvard Heart Letter

Ask the doctor: Can stopping aspirin cause heart problems?

Q. I've read that if you take aspirin every day, stopping it temporarily increases your chance of having a heart attack even higher than it would have been if you had never taken aspirin. Is that true? If I need to stop taking aspirin for some reason, is there a safer way to do it than stopping cold turkey?

A. What you are describing is sometimes called the rebound effect or rebound phenomenon. It occurs when a person stops taking a medication and the symptoms or problem that the medication had controlled reappear, but more severely than before the person started taking the medication. Although a rebound effect has been seen with some beta blockers and some sedatives used to treat insomnia, it is unlikely this happens with aspirin.

Aspirin helps prevent heart attacks and the most common form of stroke (ischemic stroke, caused by a blood clot) by making platelets in the bloodstream less "sticky." It does this by inactivating an enzyme called cyclooxygenase (COX). Without this enzyme, platelets have a difficult time sticking to each other, a key step in the formation of a blood clot inside an artery.

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