Aspirin, the original wonder drug, has long been a go-to medicine for millions, a Jack-of-all trades remedy that is readily available and cheap. Championed for its ability to relieve pain, fever and inflammation, aspirin has been a staple in home medicine cabinets and first-aid kits for more than a century.

Yet in recent years its reputation has been sullied by recognition of potentially serious side effects, especially dangerous bleeding in the gastrointestinal tract or the brain. Given aspirin’s longevity and over-the-counter status, those risks are sometimes overlooked by consumers who take it with less care than is medically warranted.

Widespread reports that aspirin can help prevent heart attacks, strokes and colorectal cancer have prompted many people to swallow either a regular or low-dose (baby) aspirin every day without first consulting their doctors or taking their susceptibility to complications into account. People who rely solely on aspirin’s preventive abilities or advice from friends and family may use it inappropriately, tipping the balance more toward risks than benefits.

Whether aspirin might be a miracle or a menace for you depends largely on knowing where you fit on the spectrum of its known benefits and risks. There is one important exception: If you think you are having a heart attack, immediately after calling 9-1-1, chew a regular 325-milligram aspirin or four low-dose ones in hopes of limiting the heart-damaging effects of a clot.

Unlike anticoagulant drugs, which interfere with clotting factors in the blood, aspirin works by stopping blood platelets from sticking together to form clots that can block an artery. In people who have already suffered a heart attack or stroke or are known to have seriously narrowed blood vessels feeding the heart or brain, daily aspirin therapy can reduce the risk of a future heart attack or stroke.

Men older than 50 and women older than 60 with diabetes who also have one or more other risk factors for heart disease, such as high blood pressure or smoking, may also benefit from daily aspirin use.


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