Day 10: The Role of Aspirin in Heart Health

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Day 10: The Role of Aspirin in Heart Health

Host:

Doctor Warrick

Mar 18, 2025

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28 Day Challenge

Low-dose aspirin is sometimes recommended for those at high risk of heart disease, but it’s not for everyone.

Welcome to the Younger Longer 28-Day Healthy Heart Challenge, a transformative podcast series designed to help you take control of your heart health and live a longer, healthier life. Over the next 28 days, we’ll guide you through a comprehensive journey covering key aspects of cardiovascular wellness—nutrition, exercise, stress management, medical awareness, and lifestyle choices.

Each daily episode is packed with expert insights from Dr. Warrick Bishop, best-selling author and cardiologist dedicated to preventing heart disease before it becomes a life-threatening issue. Using the latest science and practical strategies, this series empowers you to make heart-healthy choices and build habits that will support your well-being for years to come.

What You’ll Learn in the 28 Days:

✔ Understanding Your Heart – How it functions and why proactive care is essential.
✔ Heart-Healthy Nutrition – The best foods to fuel your cardiovascular system.
✔ Exercise & Movement – The role of physical activity in strengthening your heart.
✔ Stress & Mental Well-being – Managing stress and anxiety for a healthier heart.
✔ The Power of Sleep – How sleep quality impacts cardiovascular function.
✔ The Impact of Smoking & Alcohol – Making informed lifestyle changes.
✔ Supplements & Medical Insights – Understanding key nutrients and medical checkups.
✔ Advanced Heart Testing & Risk Factors – Going beyond traditional risk assessments.
✔ Sustaining Long-Term Heart Health Habits – Turning knowledge into action for lifelong benefits.

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Transcript

Hi, and welcome to day 10! Today, we're talking about aspirin, and I love discussing this topic. Aspirin is such a wonderful drug.

It was first patented by the German drug company Bayer in the 1800s, believe it or not. Since then, billions of these tablets have been produced and consumed worldwide, making it one of the most ubiquitous pharmaceutical agents. Aspirin does a heap of things—it keeps the blood thin by preventing platelets (which are involved in clot formation) from clumping together. It’s also effective for pain and inflammation because it affects prostaglandins, which play a role in temperature regulation, pain sensation, and blood clotting.

In heart health, we primarily use aspirin for people with plaque buildup in their arteries. It’s almost a non-negotiable for individuals who have already had an event such as a stroke, heart attack, stent placement, or bypass surgery. These people are at high risk, and aspirin helps prevent a second event—a strategy known as secondary prevention.

For those allergic to aspirin, alternative agents are available. However, if you have unhealthy arteries or have experienced a cardiovascular event, aspirin is one of the most affordable and effective medications to reduce your risk of further complications.

One of the more confusing aspects of aspirin use is whether people should take it before they have any heart problems. At first glance, this seems like a good idea—why not take aspirin to prevent an issue before it arises? However, taking aspirin without a clear medical reason can pose risks. Since aspirin thins the blood, it increases the risk of bleeding. For people with healthy arteries, the potential harm of aspirin often outweighs the benefit, which is why we generally do not recommend it for primary prevention.

In my own practice, I focus on identifying high-risk individuals who may look healthy on the outside. I often use a calcium score scan to assess whether plaque is present in their arteries. If I find someone with high-risk plaque—essentially, a lot of “rust in the pipes”—then I believe they might benefit from taking aspirin preemptively.

Interestingly, we don’t yet have randomized controlled trials to support this approach. However, if we follow the logic, it makes sense. If someone is going to have a heart attack at midnight, and we know that giving them aspirin at 12:00 sharp would help, then giving it to them at 11:59 should also be beneficial. By extension, if we identify high-risk patients and start aspirin treatment days, weeks, or months earlier, the benefits could be significant.

There’s a lot more to explore on this topic, so be sure to check out today’s resources. Additionally, some research suggests that aspirin may reduce the risk of colorectal cancer recurrence, which is another fascinating area of study.

That’s it for today. I wish you the very best—keep going with your challenge, and I hope you live as well as possible for as long as possible. Take care, and bye for now.

Are You at Risk of a Sudden Heart Attack? How Healthy is Your Heart? Really?

Heart disease is the #1 killer in the Western World. In Australia, someone dies every 28 minutes from heart disease. That’s 51 people a day. In the US, someone has a heart attack every 40 SECONDS! Fortunately, many heart attacks are preventable. However, regular exercise and eating healthy are no guarantee you won’t succumb to this silent killer.

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Transcript English

Hi, and today is day 10, and we're talking aspirin, and I love talking about aspirin. It's such a wonderful drug. It was, well, first patented by the German drug company Bayer, and that was in the 1800s, believe it or not. Billions of this tablet have been produced and consumed worldwide, so it is almost the ubiquitous pharmaceutical agent. things called platelets, which are part of a clot. It stops them from clumping together. But aspirin is also good for pain and inflammation because it affects prostaglandins. So it can lower your temperature, it can reduce your pain, and it can stop your platelets being too sticky. We use it in hearts. particularly in people who have a build-up of plaque in their arteries, and specifically, it's almost a non-negotiable for people who have had an event with their arteries, an event such as a stroke, a heart attack, a stent, bypass grafting. These are people who are known to have a problem, and we're looking to prevent a second problem. Aspirin works at doing this. Now, some people are allergic to aspirin, and there are agents that we can use as a substitute, but the... idea being that if you've got unhealthy arteries, if you've had an event, then to prevent a second event, and we call that secondary prevention, thinning the blood using antiplatelet agents, aspirin being the cheapest and most broadly available, really works. One of the confusing bits though is, should you be on aspirin before you have a problem? Well, this is super confusing because if you think about it, Sounds like not a bad idea, but just taking aspirin alone for no good reason, like any agent, any medication, any drug, could carry a downside without an upside. So if you've got healthy arteries, we believe that taking aspirin probably carries greater risk than not. And that's because the thinning of the blood leads to increased risk of bleeding. No question for people who've had an event with their arteries, they should be on aspirin. But for people who haven't had an event, it's not as clear. And we probably wouldn't recommend it broadly. In my own practice, though, I'm really, really interested at looking at people who look well on the outside. And I'll often get a scan of their heart. a scan called a calcium score, so that we know if there's plaque in the arteries. Now, if I identify someone who's got high-risk plaque, lots of rust in the pipes, for want of a better term, then I would think that those people are likely to benefit from taking aspirin preemptively. Although, interestingly, we have no data, no randomized controlled trials at this stage that support that. But if you think it through, if you find someone who's at really high risk, before they've had an event, and let's say they have their heart attack at 12 o'clock at night for ease, and for the sake of this conversation, if we could catch that person and give them their aspirin at 11.59, then that would have to be helpful, because we know if we gave those people their aspirin at 12 o'clock sharp, all our research suggests that it's going to be beneficial for them. So if we got them at an hour before, a day before, a week before, or a month before, then if we are dealing specifically with those high-risk patients, it makes logical sense. that it should bring a benefit. Well, there's lots more in the resources provided for this day. So do check those out because this is a really interesting story. There's also a little bit of information that aspirin may reduce risk of recurrence of colorectal cancer. I'm going to leave it for today. I do wish you the very best. I hope you live as well as possible for as long as possible and keep going with your challenge. Take care and bye for now.

Please Note: Before embarking on the Younger Longer 28-Day Heart Health Challenge, it's essential to consult with your General Practitioner (GP) to ensure it's safe for you to participate, especially if you have existing health conditions or risk factors. Pre-exercise screening is recommended to identify any medical conditions that may increase the risk of adverse events during physical activity.