Why a healthy lifestyle (not a daily aspirin) is key to preventing heart disease

Heart Health

by Michael Sills, MD

Mar 22, 2019

After decades of viewing daily low-dose aspirin as the standard recommendation for preventing cardiovascular disease, it seems the time for change has come.

There has been ongoing discussion and study about the value of aspirin for over 30 years in both the treatment and prevention of heart and vascular diseases. For years, doctors prescribed aspirin for all patients needing to lower their risk of these diseases.

But the American College of Cardiology and the American Heart Association now recommend aspirin not be prescribed in the absence of known coronary or vascular disease. Instead, for most people, treatment should focus on healthy lifestyle habits, including physical activity, diet and control of factors like cholesterol, diabetes risk and blood pressure.

Related: Could your toothbrushing habits predict your risk of heart disease?

New research reveals the potential risks of aspirin

You may be wondering why this sudden change in guidelines. We know that any medication has the potential for side effects, complications and interactions. What we’ve learned through research is that aspirin therapy comes with a significantly increased risk of bleeding that can potentially offset its value for prevention of cardiovascular events. As a result, it should no longer be routinely used unless you’ve had an evaluation and discussion with your physician about your individual risk of cardiovascular disease and your risk of bleeding. Aspirin is a powerful medication and needs to be viewed like every other medication in terms of its risks and benefits. 

Clearly, the era of universal aspirin therapy is over. So, what does this mean for you?

It means aspirin therapy is now reserved for select “high-risk” patients. For people who have had open-heart surgery or stents inserted, or experienced a heart attack or stroke, aspirin can still be life-saving. But if you don’t qualify as high-risk or already have a diagnosis of heart disease, aspirin should not be part of your preventive regime for keeping your heart healthy.

Aspirin is a powerful medication and needs to be viewed like every other medication in terms of its risks and benefits. 

If you are currently taking a daily dose of aspirin, talk to your doctor about tailoring your treatment plan for your individual needs — and about whether aspirin is still right for you.

It also means a greater emphasis on starting, and maintaining, those healthy habits we already know are good for us. The American College of Cardiology agrees that the most effective way to prevent cardiovascular disease, heart failure and atrial fibrillation is by living a healthy lifestyle.

Preventing heart disease through a healthy lifestyle

Let’s discuss about what we mean by “healthy lifestyle.”

Eat a heart-healthy diet.

A heart-healthy diet should center around vegetables, fruits, nuts, legumes, fish and whole grains. You should limit your consumption of red meats and processed meats, refined carbohydrates, trans fats and foods high in added sugar.

Related: Why I went plant-based and why my patients should, too

Make physical activity a priority.

Aim for at least 150 minutes of moderate exercise or 75 minutes of vigorous exercise a week. Beyond dedicated exercise time, simply try to move more and sit less throughout your day. If you’re new to exercise, find an activity you enjoy — walking around the neighborhood, group fitness classes, yoga, even gardening. Start small, but start today.

Quit smoking.

If you smoke, talk to your doctor about steps you can take today to quit.

Take control of your numbers.

There are many contributing factors that play a role in influencing your heart health and overall wellbeing. Maintain regular touch points with your primary care physician to help keep track of these key indicators:

How healthy is your heart? Take the heart disease quiz and find out.

About the Author

Michael Sills, MD, is a cardiologist on the medical staff at Baylor Scott & White Heart and Vascular Hospital – Dallas. His clinical interests include diagnostic and preventive cardiology as well as cardiac imaging. He is an avid runner, chef and proud grandfather.

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