Can aspirin prevent it?
People who have had one heart attack are at increased risk of a second. Research shows small doses of aspirin - 75 to 150mg - daily can prevent heart attacks, but only half to three-quarters of those at risk are taking it.
Why isn't everyone at risk on aspirin? GPs do not routinely prescribe aspirin for everyone at risk of heart attacks, largely due to pressure of work. However, patients are also guilty of not taking prescribed aspirin, often because it seems such an innocuous little drug.
How does aspirin help?
It prevents platelets in blood - which create coagulation when there is a wound - from sticking together and forming a clot. It has nothing to do with being a painkiller. Taking aspirin reduces the risk of suffering or dying from a further heart attack by 25 per cent, according to large international studies.
Who should take aspirin?
Just about anybody who has had a heart attack, heart surgery or who suffers from angina (chest pain). It may also help to prevent a second stroke, but it is essential to confirm by CT scan that the stroke was caused by a blood clot, not a haemorrhage, as aspirin can worsen haemorrhage. The death rate in the two years after a first heart attack or stroke in people who take aspirin is 130 per 1,000, compared to 170 per 1,000 without aspirin.
How long do I have to take it?
Indefinitely under your GP's supervision. It's cheaper to buy aspirin over the counter (about £3 for a year's supply) than on prescription, unless you are exempt from charges. If you are allergic to aspirin or have an active peptic ulcer, you should not take aspirin long-term.
Is aspirin risk free?
Virtually. There are risks of a stomach ulcer or, more rarely, brain haemorrhage, but these are vastly outweighed by aspirin's protective effect on the heart.
So should healthy people take aspirin to prevent heart disease?
So far the consensus is no. If you have no history of heart disease, the side-effects of long-term aspirin on the gut outweigh the benefits.