Does an aspirin a day keep heart disease away??

Q: I'm 39 years old and as far as I know healthy- I exercise a few times a week, eat relatively healthy, and don't smoke. However, my mom and dad (both in their late 60's) have heart disease.  I'm told therefore, that I am at risk. My question to Dr. Tam is- should I start taking a baby aspirin a day to help prevent heart disease?

A: First, congrats on taking care of yourself! You are correct that family history of heart disease is a personal risk factor for heart disease. Plaque build-up in the arteries, "atherosclerosis", can start early in our lives, typically accelerating and manifesting itself in women after the age of 55.  So the best thing to do in your 30's and 40's is to monitor blood pressure and cholesterol levels, and ensure a healthy weight. I would emphasize that diet, exercise (at least 30 minutes of cardio 5 times a week), and other lifestyle modifications are critical toward reducing your risk of heart disease. In addition, smoking is a major contributor to damaged arteries and should therefore be avoided. 
Aspirin works to decrease blood clots on the surface of arterial plaques. For years, physicians assumed that taking a daily aspirin could help prevent heart attacks in otherwise healthy women (just as it does in men). However, it wasn't until the Women's Health Study that women were included in adequate numbers to draw meaningful conclusions. In fact, this long term study found that among almost 40,000 healthy

women, aspirin did NOT prevent heart attacks as it did in men.  However, a benefit was found for aspirin in preventing strokes in women.  The U.S. Preventive Service Task Force, a leading guideline authority, recommends that aspirin be used for stroke prevention in women > 55 years when benefits outweigh the risk of potential bleeding (a possible side effect with aspirin).  They state that there is insufficient evidence to recommend aspirin for primary prevention in women <55 years like yourself. Therefore, the jury is still out on this one.  I would recommend instead to continue your heart healthy diet and routine exercise, ensure at least 6-8 hours of sleep a night, drink alcohol in moderation, and scheduling an appointment with your physician to check your blood pressure, cholesterol, and other possible risk factors.