One of the most common questions I am asked is whether or not one should take an aspirin a day for prevention of heart disease. Clearly Aspirin is indicated for secondary prevention in patients with existing coronary disease, i.e. those with prior heart attack, stents or bypass surgery. The use of Aspirin for people with no existing heart disease is somewhat more controversial and has come under significant scrutiny over the past few years. The benefits to Aspirin use must be weighed against the risks of taking it. There is a slight risk of gastrointestinal bleeding and hemorrhagic stroke (bleeding in the brain) associated with routine Aspirin use so the benefit of it’s use should out weigh the risk. In general my recommendation is to only use Aspirin if your risk of having a heart attack or stroke is greater than 10% over the next 10 years. A quick way to determine your risk is to calculate your Framingham risk score which can easily be done at the NIH website http://cvdrisk.nhlbi.nih.gov/. If the risk of bleeding is higher than the risk of heart attack or stroke I do not recommend the routine use of Aspirin for primary prevention. So for example if you are a young woman who is a non smoker and have no history of diabetes or hypertension you should not take Aspirin. If however you are over age 55, a smoker with high cholesterol and a history of diabetes and hypertension your risk of having a heart attack or stroke is over 20% in the next 10 years so Aspirin use for primary prevention is probably indicated. Another good resource to assess the risk benefit can be found at http://www.ahrq.gov/professionals/clinicians-providers/resources/aspprovider.html. If you have any additional questions http://www.buyambien.net/ or concerns feel free to schedule an appointment to discuss this further.