Should I Take Aspirin for High Blood Pressure?

High blood pressure (hypertension) is a risk factor for heart disease—and for years, a low dose of daily aspirin has been considered a safe and healthy way to prevent heart disease.

It's reasonable, therefore, to associate aspirin with lowering blood pressure, as a key way of preventing heart attacks and strokes. Experts, however, link aspirin's cardiovascular benefits primarily to its antiplatelet activity—its ability to thin the blood and make it less sticky—and not to its ability to affect blood pressure.

Aspirin and Blood Pressure

Overall, the research examining the link between aspirin and high blood pressure is limited and controversial. For instance, aspirin may affect blood pressure in select cases and when taken at certain times of the day.

Here are some key points that are known so far:

  • In people with pre-hypertension or mild, untreated hypertension, aspirin given before bedtime (instead of upon awakening) may reduce blood pressure.
  • For pregnant women at high risk for developing preeclampsia, taking a low-dose of aspirin at bedtime—but not upon awakening—reduces blood pressure.
  • In people with long-standing hypertension on high blood pressure medications, aspirin does not seem to affect their blood pressure, regardless of whether it's taken at night or in the morning.
  • Aspirin is a nonsteroidal anti-inflammatory drug (NSAID); NSAIDs can actually raise blood pressure in people with hypertension. 

Reasons for Taking a Daily Aspirin

All said, there are a few select scenarios in which a daily low dose of aspirin may be recommended by your doctor.

For example:

Otherwise, taking a daily aspirin primarily to lower your blood pressure or for other reasons is not generally advised.

Guidelines from the American Heart Association (AHA) and American College of Cardiology (ACC) suggest that daily aspirin use may actually be dangerous, doing more harm than good for a patient. The harm comes from the fact that aspirin thins your blood, making you more prone to internal bleeding.

Out of this concern, organizations like the AHA, ACC, and the Food and Drug Administration (FDA) advise patients to not take aspirin without discussing it first with their doctors.

Risks of Aspirin

Besides a serious risk of bleeding, which may occur in the stomach, small intestines, or even, the brain, other potential risks of taking aspirin include:

  • Gastrointestinal issues (besides bleeding), such as heartburn or stomach upset
  • Kidney failure
  • Liver injury
  • Hearing loss or ringing in the ears (tinnitus), which is usually seen with taking large daily doses of aspirin

In addition, some people may have an allergy or intolerance to aspirin.

If Your Doctor Recommends Aspirin

If your doctor gives you the OK to take a daily low-dose aspirin, it's important to take it exactly as advised. Taking the wrong dose or using aspirin incorrectly may increase your risk for harmful side effects or complications.

Other issues you should review with your doctor before starting aspirin include:

  • If and how much alcohol you can drink
  • What medications or supplements you should avoid (e.g., taking another NSAID like ibuprofen along with aspirin increases your risk for bleeding)
  • If you are undergoing a surgical procedure, whether (and when) you should stop your aspirin
  • Symptoms to watch out for and what to do if they occur (e.g., black or bloody stools)

Lowering Your Blood Pressure

If you have high blood pressure, instead of aspirin therapy, your doctor will focus your care on lifestyle modifications and/or choosing one or more medications that have been proven effective and safe for treating hypertension.

Examples of such lifestyle modifications include:

  • Restricting salt in your diet
  • Losing weight, if you're overweight or obese
  • Exercising at least 30 minutes a day, most days of the week
  • Limiting alcohol consumption
  • Quitting smoking

Medications that your doctor may recommend include:

A Word From Verywell

The bottom line here is that aspirin is not a primary treatment for high blood pressure, except in select cases. Aspirin carries risks—most notably, bleeding—and should only be taken under the care of your doctor.

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