Top Doctors: Aspirin and your heart

Ultracheap and easy to take, aspirin may play a bigger role in your life than soothing the occasional headache. Doctors say it can boost your body's ability to fend off heart attacks.

But a daily dose of aspirin isn't for everyone. For many people, it could be unnecessary or even harmful. Here's what you should know:

1. YOU MIGHT NOT NEED A DAILY ASPIRIN

"Those who are at risk should consider it, and those who aren't shouldn't," said Dr. Stephen Green, associate chairman of cardiology at North Shore University Hospital.

Daily aspirin may be appropriate for people with heart disease, he said. The same goes for smokers, diabetics, people with high blood pressure and those whose mothers had a heart attack before the age of 65 or fathers had one before 55, Green said.

But in other people, the risk for gastric bleeding may outweigh the lowered risk for a heart attack. "If you have very low risk and you're 30, 35 or 40, the risk is worse than the benefit," he said, adding that elderly people who aren't in a risk group may not need to take aspirin either.

2. ASPIRIN CAN BE DANGEROUS

"Aspirin should not be used if someone has an allergy to aspirin, has active bleeding or stomach ulcers," said Dr. Lloyd Lense, associate clinical professor of medicine at Stony Brook University School of Medicine. "Complications from aspirin may be influenced by kidney disease, liver disease or taking other medications."

Aspirin is a blood thinner that reduces the ability of blood to form the blockages known as clots. If you're already taking another blood thinner, aspirin could spell trouble by making it too easy for your body to bleed without stopping.

3. ASPIRIN WON'T PREVENT ALL HEART ATTACKS

In fact, aspirin typically reduces your chances of having an attack by just 10 to 20 percent, Green noted. The difference is more significant, he said, for people who are at greater risk for a heart attack.

4. SIZE MATTERS

Make sure to ask your doctor about just how much aspirin you should take. "The dose should be 75 to 325 milligrams a day, but it depends on the medical circumstances and the other forms of medications that patients are taking," Lense said.

A typical low-dose aspirin (sometimes called a baby aspirin) contains 81 milligrams, and a regular-strength aspirin has 325 milligrams.

5. DURING A HEART ATTACK

If you feel like you're having a heart attack, an aspirin might help reduce the damage. "We know it saves lives," Green said.

Just make sure to chew the aspirin, Green added. That helps it get to work faster, he explained, and may make a big difference compared with swallowing a coated aspirin that takes longer -- hours, even -- to take effect.

Lense offers similar advice. He also recommends chewing an aspirin if you think you're having a heart attack and says that a 325 milligram pill, preferably not coated, would be ideal.

This is the first installment of a 26-week series in which Newsday presents Castle Connolly's list of top LI doctors. Click here to see the full list.

This week, we're featuring LI's top cardiologists.

Dr. Larry Altschul, 540 Union Blvd., West Islip; 631-669-2555

Dr. Maliakal Joseph Anto,8 Greenfield Rd., Syosset; 516-496-7900

Dr. Mark Borek, Stony Brook Cardiology, 26 Research Way, East Setauket; 631-444-1066

Dr. William Breen, 43 Crossways Park Dr., Woodbury; 516-938-3000

Dr. David Brown, Stony Brook University Med. Center, Division of Cardiology, Health Science Center, Stony Brook; 631-444-3699

Dr. Kul Chadda, South Nassau Community Hospital, Electrophysiology Services, 1 Healthy Way, Oceanside; 516-632-3418

Dr. Mathew Chengot, Amityville Heart Center, 129 Broadway, Amityville; 631-598-3434

Dr. Michael Chesner, 325 W. Park Ave., Long Beach; 516-432-2004

Dr. Marvin Cramer, 225 Community Dr., Great Neck; 516-504-0474

Dr. Ronald D'Agostino, 1129 Northern Blvd., Manhasset; 516-627-2121

Dr. Edward Davison, 300 Franklin Ave., Valley Stream; 516-599-8280

Dr. John Dervan, 220 Belle Mead Rd., East Setauket; 631-941-2273

Dr. Robert Dresdale, 225 Community Dr., Great Neck; 516-504-0474

Dr. Ari Ezratty, 100 Port Washington Blvd., Roslyn; 516-365-6444 or 516-570-6907

Dr. Thomas Falco, 1279 E. Main St., Riverhead; 631-727-2100

Dr. Frederick Fein, 120 Mineola Blvd., Mineola; 516-663-4480

Dr. Aaron Gindea, 800 Community Dr., Manhasset; 516-627-6622

Dr. Louis Gleckel, 2 Ohio Dr., Lake Success; 516-622-6060

Dr. Steven M. Goldberg, 1010 Northern Blvd., Great Neck; 516-390-2430

Dr. Mark Goodman, 975 Stewart Ave., Garden City; 516-222-8610

Dr. Stephen Green, Dept. Cardiology, 300 Community Dr., Manhasset; 516-562-4100

Dr. Steven Greenberg, 100 Port Washington Blvd., Arrhythmia Center, Roslyn; 516-562-6672

Dr. Ronnie Hershman, 1 Hollow Lane, Lake Success; 516-869-5400

Dr. Mansoor Jelveh, 875 Old Country Rd., Plainview; 516-935-8877

Dr. Allen Jeremias, Stony Brook University Medical Center, Health Science Center, Stony Brook; 631-444-1069

Dr. Steven Kobren, Great Neck Med. Group, 488 Great Neck Rd., Great Neck; 516-482-6747

Dr. Jerome Koss, 3003 New Hyde Park Rd., New Hyde Park; 516-358-5401

Dr. Justine Lachmann, 120 Mineola Blvd., Mineola; 516-663-4481

Dr. Lloyd Lense, Stony Brook Cardiology, 26 Research Way, East Setauket; 631-444-1066

Dr. Michael Masciello, 540 Union Blvd., West Islip; 631-669-2555

Dr. Michael Matilsky, Three Village Cardiology, 210 Belle Mead Rd., East Setauket; 631-689-1400

Dr. Guy Mintz, 287 Northern Blvd., Great Neck; 516-482-3401

Dr. Thomas Nicosia, 1615 Northern Blvd., Manhasset; 516-627-9355

Dr. Thomas Pappas, 100 Port Washington Blvd., Roslyn; 516-390-9640

Dr. Michael Poon, Stony Brook Health Science Center, Stony Brook; 631-444-5400

Dr. Philip Ragno, 1401 Franklin Ave., Garden City; 516-877-2626

Dr. Edward Rutkovsky, 2035 Lakeville Rd., New Hyde Park; 516-328-9797

Dr. Carl Schreiber, 70 Glen St., Glen Cove; 516-484-7893

Dr. Richard Shlofmitz, 100 Port Washington Blvd., Roslyn; 516-390-9640

Dr. Hal Skopicki, University Physicians at Stony Brook, 3001 Expressway Dr. N., Islandia; 631-444-9600

Dr. Sergio Sokol, Five Towns Heart Imaging, 650 Central Ave., Cedarhurst; 516-804-8590

Dr. Louise Spadaro, St. Francis Hospital, 100 Port Washington Blvd., Roslyn; 516-562-6653

Dr. William Tenet, 1155 Northern Blvd., Manhasset; 516-627-4330

Dr. Ira Weg, 158 Hempstead Ave., Lynbrook; 516-593-3541

Dr. Marc Weinberg, West Carver Medical Associates, 200 W. Carver St., Huntington; 631-421-0020

Dr. Steven Zeldis, 200 Old Country Rd., Mineola; 516-877-0977

CARDIAC ELECTROPHYSIOLOGY

Dr. Ram Jadonath, 300 Community Dr., Manhasset; 516-562-2300

Dr. Joseph Levine, 100 Port Washington Blvd., Roslyn; 516-622-1011

Dr. Eric Rashba, Stony Brook University Medical Center, Cardiology HSC Bldg. Stony Brook; 631-444-3575

INTERVENTIONAL CARDIOLOGY

Dr. Meyer Abittan, St. Francis Hospital, The Heart Center, 100 Port Washington Blvd., Roslyn; 516-627-1155

Dr. Andrew Berke, 100 Port Washington Blvd., Roslyn; 516-365-2211

Dr. Andrew Lituchy, 100 Port Washington Blvd., Roslyn; 516-365-4888

Dr. Lawrence Ong, North Shore University Hospital, Dept. Cardiology, 300 Community Dr., Manhasset; 516-562-4100

Dr. George Petrossian, New York Cardiology Group, 1405 Old Northern Blvd., Roslyn; 516-484-6777

How they were picked

Castle Connolly Medical Ltd. is a health care research and information company founded in 1991 by a former medical college board chairman and president to help guide consumers to America's top doctors and hospitals. Castle Connolly's established survey and research process, under the direction of a doctor, involves tens of thousands of doctors and the medical leadership of leading hospitals.

Castle Connolly's team of researchers follows a rigorous screening process to select doctors on national and regional levels. Using mail and telephone surveys, and electronic ballots, they ask physicians and the leadership of top hospitals to identify exceptional doctors. Careful screening of doctors' educational and professional experience is essential to the committee. Not every good physician makes the list. Rather, the list is a way for patients to get started on their search for the best medical professional. Newsday is not part of the selection process.

Doctors do not and cannot pay to be selected and profiled as Castle Connolly Top Doctors.

To see the whole list . . .

Who else is on the list of Top Doctors? More than 6,000 listings are in the New York Metro Area edition of "Top Doctors," published by Castle Connolly Medical Ltd. The softcover list price is $34.95.

For more information, go to castleconnolly.com, or call 800-399-DOCS.