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Aspirin is commonly given to patients with heart disease (angina or heart attack). It has been mentioned that it may also prevent heart attacks. Should normal healthy middle aged or older people also take aspirin to prevent heart attacks? Does it prolong life? Thanks for your insight.

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This is a good and pragmatic question.

Just to give some insight, the benefits of aspirin in high risk patients (with acute or previous vascular disease or some other predisposing condition) are explicitly shown. I recommend reading the freely available meta-analysis published in BMJ in 2002.

Naturally, the patients without any disease or predisposing conditions are low risk patients, or normal as the asker terms.

Clinical guideline by the American College of Physicians, American College of Cardiology Foundation, American Heart Association, American Association for Thoracic Surgery, Preventive Cardiovascular Nurses Association and Society of Thoracic Surgeons clearly states that aspirin is recommended only for patients with Stable Ischemic Heart Disease.

Clinical guidelines by the European Society of Cardiology and Other Societies on Cardiovascular Disease Prevention in Clinical Practice gives some more comprehensive insight.

Chapter 4.10.1 outlines the "Antiplatelet therapy in individuals without overt cardiovascular disease".

Risk of vascular mortality was not changed by treatment with aspirin. Aspirin cannot be recommended in primary prevention due to its increased risk of major bleeding

To answer your question, no, it is not useful for healthy individuals to take aspirin, since the harm caused exceeds the potential benefits.

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