Does aspirin lower blood pressure?
Aspirin, or salicylic acid, is a drug that is available over the counter (OTC) that you might have taken to help manage pain or a fever.
Aspirin has other medicinal properties alongside pain relief. It also affects the consistency of your blood, making it thinner and less sticky by blocking the action of platelets. Platelets are the cells responsible for blood clotting.
In some people, taking a low dose of aspirin daily may help reduce the chance of stroke due to blood clots and lower your risk of experiencing a cardiac event, such as a heart attack.
But it does not typically lower blood pressure when you take it on its own.
Aspirin and blood pressure
According to the American College of Cardiology (ACC), around 46% of American adults have high blood pressure, also known as hypertension.
Aspirin has many uses, including preventing blood clots, thinning your blood, and helping your body process omega-3 fatty acids. As a result, there is debate as to whether aspirin can help lower blood pressure in people with hypertension.
Studies show taking daily aspirin does not specifically lower blood pressure in people with hypertension. But aspirin may be key in preventing high blood pressure during pregnancy, or pre-eclampsia, which occurs in around 4% of pregnancies in the United States.
Although aspirin may not be the best choice of medication for lowering blood pressure, it may protect your heart health.
According to the Food and Drug Administration (FDA), taking aspirin can lower your risk of experiencing a heart attack or another stroke if you have cardiovascular disease or have previously experienced a stroke.
Despite aspirin being available to buy OTC, if you have high blood pressure, cardiovascular disease, or have had a stroke, you should only take it if a doctor prescribes it to you. This is because, like any medication, there are risks of side effects. These side effects may be more severe for people with these health conditions.
Risks of aspirin
Taking aspirin, even in a low dose, has its risks.
If you have hypertension, you may have an increased risk of experiencing heart failure while taking aspirin.
According to a study from 2021, if your blood pressure measures higher than 131/71 mm Hg, you are more likely to experience heart failure if you take aspirin.
Aspirin thins your blood. This means if you also take other medications that reduce blood clotting, it may have serious side effects. Taking aspirin with certain medications, like warfarin (Coumadin), can double your risk of bleeding.
Other medications to avoid taking with aspirin include:
- pain medications like ibuprofen (Advil) and prednisolone (Orapred)
- anti-hypertensives like furosemide (Lasix)
- certain mental health medications like lithium
- certain glaucoma medications like acetazolamide (Diamox)
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If you take aspirin for a long time, you may be at risk of developing ulcers in your stomach. Stomach ulcers are sores that develop on the lining of your stomach.
If you have diabetes, you may be more at risk of developing a stomach ulcer from taking aspirin for long periods.
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Dangers for children
In general, doctors do not recommend that children take aspirin. There is an increased risk of a condition called Reye’s syndrome, a disease that affects the brain and the liver and can even be fatal.
Who should take aspirin?
Doctors are unlikely to prescribe a long-term course of low dose aspirin to you if you have a history of stomach ulcers or are taking another blood-thinning medication or anticoagulant.
If a doctor thinks you may benefit from low dose aspirin, they must ensure you are not at risk of bleeding or have high blood pressure. These factors increase your chance of adverse reactions to aspirin.
People who may benefit from low dose aspirin include:
According to the American College of Obstetricians and Gynecologists (ACOG), low doses of aspirin may help to prevent pregnant people who are at risk of pre-eclampsia from developing the condition during their pregnancy.
The ACOG recommends to start taking 81 mg per day of aspirin between 12 and 28 weeks of gestation until the baby arrives.
If you do not have any risk factors for pre-eclampsia, a doctor is unlikely to prescribe aspirin to you. Always speak with a doctor before taking any new medications during pregnancy.
Prevention of heart disease and stroke
Heart disease is responsible for more than 1 in 5 deaths in the United States. According to research from 2022, adults over the age of 40 years with no symptoms of cardiovascular disease or stroke may benefit from taking low dose aspirin daily if they have a greater risk of developing the condition.
This can help to prevent the development of cardiovascular disease and reduce the chances of experiencing heart attack or stroke.
But note that the study also finds no benefit in using aspirin to prevent cardiovascular events in people older than 60 because of the increased risk of internal bleeding with age.
If you have any risk of bleeding, gastrointestinal ulcers, or high blood pressure, a doctor is unlikely to prescribe low dose aspirin.
If you have hypertension, making sure you get the most effective treatment will help reduce your risk of developing heart disease or experiencing a heart attack. It will also improve your general health and well-being.
For some people, the solution may be as simple as changing some of your lifestyle habits. According to a review from 2019, these changes include:
- Diet: Increasing your fresh fruit and vegetable intake while reducing the amount of trans-fat, sugar, and salt can help to lower blood pressure.
- Exercise and physical activity: Taking part in at least 150 minutes of aerobic exercise per week and reducing the amount of time you spend sitting can help to lower your blood pressure.
- Maintaining a healthy weight: If you are overweight, losing weight can help lower blood pressure.
There are also a variety of medications available that a doctor may prescribe to you if you receive a diagnosis of hypertension. Which medication is best for you will depend on many different factors, such as age.
Some of these medications include:
- Angiotensin-converting enzyme (ACE) inhibitors, such as moexipril (Univasc) and lisinopril (Qbrelis)
- Alpha-blockers prevent your arteries from narrowing and include prazosin (Minipress) and doxazosin (Cardura)
Aspirin may help to prevent heart failure in healthy adults, as well as pre-eclampsia in pregnant people. However, doctors are unlikely to recommend it to help manage hypertension.
This is because aspirin can increase your chance of experiencing a heart attack if you have hypertension.
It is important to speak with a doctor before taking any medication. Always follow the instructions of a doctor when managing hypertension.
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- Arnett D, et al. (2019). Guideline on the primary prevention of cardiovascular disease: A report of the American College of Cardiology/American Heart Association task force on clinical practice guidelines. https://www.ahajournals.org/doi/10.1161/CIR.0000000000000678?cookieSet=1#d1e1862
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- Aspirin is used to prevent cardiovascular disease. (2022). https://jamanetwork.com/journals/jama/fullarticle/2791399
- Block R, et al. (2021). Aspirin and omega-3 fatty acid status interact in the prevention of cardiovascular diseases in Framingham Heart Study. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8159885/
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- Davidson KW. (2021). Aspirin use to prevent preeclampsia and related morbidity and mortality: US Preventive Services Task Force recommendation statement. https://jamanetwork.com/journals/jama/fullarticle/2784499
- Heart disease facts. (2023). https://www.cdc.gov/heartdisease/facts.htm
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- Kılıç S, et al. (2019). The prevalence and risks of inappropriate combination of aspirin and warfarin in clinical practice: Results from WARFARIN-TR study. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6335934/
- Low-dose aspirin use during pregnancy. (2023). https://www.acog.org/clinical/clinical-guidance/committee-opinion/articles/2018/07/low-dose-aspirin-use-during-pregnancy
- Mujaj B, et al. (2021). Aspirin use is associated with increased risk for incident heart failure: a patient-level pooled analysis. https://onlinelibrary.wiley.com/doi/10.1002/ehf2.13688
- New ACC/ AHA high blood pressure guidelines lower the definition of hypertension. (2017). https://www.acc.org/latest-in-cardiology/articles/2017/11/08/11/47/mon-5pm-bp-guideline-aha-2017
- Reye's syndrome. (n.d.). https://www.ninds.nih.gov/health-information/disorders/reyes-syndrome
- Sheppard A, et al. (2014). Review of salicylate-induced hearing loss, neurotoxicity, tinnitus, and neuropathohysiology. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4025186/
- Who is at risk of preeclampsia? (2022). https://www.nichd.nih.gov/health/topics/preeclampsia/conditioninfo/risk