Can Aspirin Help Prevent or Treat Strokes? Benefits and Risks

Using Aspirin for Stroke Prevention and Treatment - What You Need to Know

Aspirin is one of the most widely used medications in the world. It's an accessible over-the-counter pain reliever and fever reducer that many people take regularly for aches and pains.

But did you know that aspirin is also used to help prevent or treat strokes? It's true - when taken properly, aspirin can be an important therapy for reducing stroke risk in some people.

However, aspirin also carries risks like bleeding. Determining if aspirin is right for you to lower stroke risk involves looking at multiple factors. Let's explore how aspirin may help prevent strokes, how it's used after a stroke, who should avoid it, proper dosage and more.

How Aspirin May Help Prevent Strokes

Aspirin contains the drug acetylsalicylic acid. At lower doses, this chemical works as a blood thinner by preventing blood cells called platelets from clumping together. This helps prevent blood clots from forming in your blood vessels.

Blood clots are one of the leading causes of strokes, especially the most common type called ischemic strokes. Preventing clots helps lower your risk of having an ischemic stroke.

That's why regularly taking a low dose aspirin is sometimes recommended for people at higher risk of blood clots and stroke. The USPSTF recommends a daily low-dose aspirin for adults aged 50-59 with a 10% or greater risk of cardiovascular disease over the next 10 years.

Aspirin Dosage for Stroke Prevention

The dosage of aspirin used for stroke prevention is much lower than amounts used for pain relief or anti-inflammatory effects. This allows the blood thinning benefit while minimizing side effects like stomach irritation or bleeding problems.

For stroke prevention, the typical adult dosage of aspirin is:

• 81 mg per day
• Or 100 mg per day
• Or 325 mg every other day

Low-dose "baby" aspirin tablets are usually 81 mg. Some doctors advise taking aspirin every day, while others recommend an every-other-day regimen to further reduce bleeding risks.

It's important to only take the dosage of aspirin recommended by your doctor for stroke prevention. Taking higher amounts thinking it will work better could actually increase bleeding risks without added benefit.

Who Should Take Aspirin to Prevent Strokes?

The decision about whether aspirin is appropriate for stroke prevention is based on weighing your risk factors and overall health. Aspirin is generally considered if you have:

• A previous heart attack or stroke
• Peripheral artery disease (PAD)
• A high risk score on assessment tools like the ASCVD risk estimator
• Multiple high blood pressure readings
• Diabetes plus other cardiovascular risk factors
• Clogged arteries requiring coronary stents
• A strong family history of cardiovascular disease

Talk to your doctor before beginning daily aspirin. They can assess your risk factors and whether the benefits of aspirin for you outweigh any potential harms.

Risks and Side Effects of Daily Aspirin Use

While aspirin can help lower the chance of strokes and heart attacks, it also carries some risks. Possible side effects and complications include:

• Increased bleeding during illnesses or injury
• Abdominal pain, heartburn or stomach ulceration
• Allergic reaction involving hives, facial swelling and difficulty breathing
• Easy bruising and extended bleeding from cuts
• Heavy bleeding causing anemia
• Higher stroke risk if aspirin therapy is stopped suddenly
• Brain or other internal bleeding, especially at higher doses

People with existing ulcers, bleeding disorders, kidney problems or certain other conditions may be advised to avoid aspirin entirely due to risks.

Who Should Not Take Aspirin?

There are some groups who are often cautioned against using daily aspirin therapy:

• People under 21: Risks tend to outweigh benefits in younger people
• Pregnant women: Can transfer to and harm the fetus
• People with active bleeding: Such as gastrointestinal ulcers, hemorrhoids or bleeding disorders
• Those undergoing surgery: Should stop aspirin 7-10 days beforehand due to bleeding risks
• People taking blood thinners: Increased bleeding complications

Anyone with concerns about side effects, allergies or bleeding risks should consult their doctor before starting a daily aspirin regimen.

How to Take Aspirin Safely

If you and your doctor decide aspirin is appropriate to lower your stroke risk, follow these tips for safe use:

• Take the prescribed low dose - higher amounts don't necessarily work better
• Take with food to reduce stomach upset
• Do not double up or increase dosage if you miss a dose
• Avoid taking aspirin along with NSAIDs like ibuprofen which increase bleeding risk
• Tell your doctor about all medications you take to check for interactions with aspirin
• Watch for side effects like easy bruising or stomach pain and report them promptly

Make sure your doctor monitors you regularly while on daily aspirin to catch any complications early. Seek medical attention right away for serious symptoms like passes black or bloody stools, bloody vomit, severe stomach pain or difficult breathing.

Should You Stop Taking Aspirin?

Never stop your daily aspirin without medical guidance. Suddenly halting aspirin after taking it regularly can actually increase your risk of heart attack or stroke.

If you have been on daily aspirin and want to stop, talk to your doctor first. They will likely have you taper your dosage gradually over 1-2 weeks. This gives your body time to adjust and lowers complications.

Reasons your doctor may advise discontinuing daily aspirin include:

• You develop troublesome side effects like recurrent bleeding
• Your risk factors have changed and aspirin no longer provides net benefit
• You need to undergo surgery or a procedure that requires stopping aspirin temporarily
• You start taking medications such as blood thinners that are unsafe to combine with aspirin

Never attempt to stop or adjust your prescribed aspirin dosage without your doctor's guidance first.

Using Aspirin Immediately After a Stroke

In addition to long-term prevention, aspirin is sometimes used emergently after an acute stroke. Let's look at the evidence on aspirin for treating strokes:

How Does Aspirin Help After a Stroke?

Aspirin works as a "thinning" agent to help prevent blood clots from worsening and causing further damage after an acute stroke. It can help:

• Slow the growth of the existing clot
• Prevent additional tiny clots from forming
• Improve blood flow to the area of brain tissue deprived of oxygen

This helps limit the extent of injury to the brain. Aspirin essentially works to "buy time" until clot-busting medications or medical procedures can be used to treat the stroke.

What is the Typical Aspirin Dosage for an Acute Stroke?

In the emergency setting, the doses of aspirin given for an active stroke are higher than those used for daily prevention. This provides rapid, strong blood thinning effects.

Typical acute aspirin regimens may include:

• 160 to 325 mg tablet chewed and swallowed
• 300 mg aspirin rectally if unable to swallow
• Up to 650 mg aspirin intravenously (IV) in severe strokes

This single higher dose is used emergently rather than lower amounts. The goal is to quickly inhibit platelet activity and clotting mechanisms as much as possible to minimize any ongoing stroke damage.

Should Aspirin Be Given to Everyone Having a Stroke?

Giving aspirin immediately to those having an ischemic stroke can help limit damage. However, there are some caveats:

• It should be avoided in hemorrhagic strokes with bleeding
• It may not be advised if the person recently underwent surgery or has bleeding risks
• The risks may outweigh benefits if the stroke symptoms are very mild or improve quickly

Doctors must assess each individual case. Early imaging testing can help identify if the stroke is ischemic and likely to benefit from aspirin versus hemorrhagic.

Is Aspirin Alone Enough to Treat a Stroke?

Aspirin is not a standalone treatment for acute ischemic stroke. It is typically combined with:

• IV clot-busting drug alteplase: Powerful thrombolytic medication that dissolves blood clots
• Mechanical thrombectomy: Procedure to retrieve large clots
• Anticoagulants: Medications like heparin that prevent new clots

Aspirin helps augment these therapies. Together, they can restore blood flow and minimize permanent damage. Seeking emergency care promptly is vital, as outcomes are very time-sensitive after strokes.

The Bottom Line - Should You Take Aspirin for Strokes?

Evidence supports using aspirin both daily at low doses to prevent strokes, as well as emergently at higher doses to treat acute ischemic strokes along with other interventions.

However, aspirin does carry bleeding risks that must be weighed carefully against potential benefits. Talk to your doctor about your specific situation.

If you do begin a daily aspirin regimen, take only the prescribed amount and watch closely for side effects. Seek prompt medical help if you experience any signs of bleeding problems.

While not appropriate for everyone, when used properly under a doctor's guidance, aspirin can be an important therapy for reducing stroke risk and damage from clots. But be sure to discuss with your doctor first if aspirin may have a role in your stroke prevention or treatment plan.

Disclaimer: This article is for informational purposes only and does not constitute medical advice. Always consult with a healthcare professional before starting any new treatment regimen.