Harvard Health Letter

Who needs to be taking aspirin for cardiovascular protection?

Studies conflict about the benefits for women.

If you've had heart problems or doctors have found evidence of atherosclerosis in your arteries, the advice about aspirin is clear and gender-neutral: A daily dose will reduce your chances of dying from a heart attack or stroke. Although there's still some doubt about the optimal dose, most studies show that small doses are just as effective — and maybe even more so — than large doses, so the standard advice is to take 75 to 162 milligrams (mg) daily. In the United States, low-dose aspirin comes in 81-mg pills.

It's more confusing — and not so gender-neutral — for people who haven't had a heart problem. For men in this group, aspirin lowers the risk of heart attack but not stroke. For women, the best evidence has suggested that it's just the reverse — aspirin lowers the risk of stroke but not heart attack.

And whether regular aspirin use reduces the risk of premature death in people who are free of cardiovascular disease is debatable — especially so for women.

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