It's not uncommon for physicians whose patients have suffered a heart attack to recommend low-dose aspirin to help avert a second occurrence. The regimen typically consists of one or two low-dose tablets a day. Each tablet of low-dose aspirin — also known as baby aspirin — is about 80 milligrams. A regular strength aspirin tablet is 325 milligrams.

But what about people who have never suffered a heart attack and have a lifestyle or a family history that puts them at high risk of cardiovascular disease? Here, government guidelines are not only confusing, they also are contradictory.

The U.S. Preventive Services Task Force, a federally sponsored, independent board of medical experts, recommends the use of aspirin for men ages 45 to 79 as a "primary prevention" of heart attacks and for women 55 to 79 to prevent strokes. It adds that, for both men and women, the potential benefits must outweigh the potential harm before aspirin can be recommended. Aspirin can have serious side effects, mainly gastrointestinal bleeding.

But the U.S. Food and Drug Administration takes a different view. The FDA says it "does not believe the evidence supports the general use of aspirin for primary prevention of a heart attack or stroke."

However, the FDA and the Preventive Services Task Force agree that a low-dose aspirin regimen is suitable for most people who have suffered a first heart attack or stroke. And both say no one should begin a regimen without consulting a physician.

Dr. Charles Hennekens, whose groundbreaking research found that aspirin can prevent a first heart attack, says the decision to prescribe an aspirin regimen for those who have not suffered a heart attack should be made only by their physician. "I'd rather leave it to the judgment of the doctor than leave it to any guideline," he says. "And I certainly would never want to leave it to the individual patient."

No matter your health status, consider keeping a bottle of regular aspirin in your medicine cabinet. For anyone suffering a heart attack, it can be a lifesaver. Hennekens, a research professor at Florida Atlantic University's College of Medicine, says at the onset of heart attack symptoms, a full 325 milligram dose can reduce the death rate by 23 percent. Chewing the aspirin gets the medicine into the bloodstream fastest. If the patient is unconscious, Hennekens says put the tablet under the tongue, where it will be absorbed.

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For more information from the American Heart Association, go to