Strokes are an urgent medical emergency that require immediate attention. In fact, doctors use the acronym F-A-S-T to promote quick recognition and treatment for stroke. Knowing how critical it is to take action, many people may be tempted to treat their stroke themselves while waiting for paramedics.
“People think if they’re having a stroke they should take an aspirin,” says Carolyn Brockington, MD, neurologist at Mount Sinai Hospital. “That’s a big mistake.”
The Myth of Aspirin to Treat Stroke
Aspirin is a blood thinner than can stop the body’s production of the substance (thromboxane) that aids in clotting the blood (as well as reducing pain and fever), according to the U.S. National Library of Medicine.
The idea of taking aspirin while having a stroke stems from the fact that one type of stroke—ischemic stroke—results from a blood clot in the brain. When a patient who is having an ischemic stroke reaches the hospital, they will likely receive blood thinners to restore blood to the brain.
So why not take aspirin—an OTC blood thinner—to start your stroke treatment early?
“It might be a significant problem to actually take a blood thinner if the stroke you’re having is a bleeding stroke,” says Dr. Brockington. If you’re having a hemorrhagic stroke—or a bleeding stroke—an aspirin will make your stroke outcome worse.
The Two Types of Stroke
“We know there are two types of strokes: ischemic, which means reduction in blood flow, versus hemorrhagic, which means a blood vessel burst open and allowed blood to spill in the brain,” says Dr. Brockington. Learn more about the two types of strokes here.
Because the causes of the two types of stroke are different, they receive different treatment. Doctors treat ischemic strokes by using blood thinners to restore the blood flow to the brain, but they treat hemorrhagic strokes by trying to help the blood clot and stop pooling in the brain. Treating a hemorrhagic stroke with aspirin could make the bleeding worse and cause serious complications.
But here’s the rub: “Nobody’s going to know [what type of stroke you’re having] until you come into the emergency room and actually take a picture,” says Dr. Brockington. It is up to medical professionals to diagnose whether your stroke is being caused by a clot or by bleeding, and whether blood thinners can help treat your stroke.
Should You *Ever* Take Aspirin for Stroke?
If you’re having symptoms of stroke, do not take an aspirin. Although OTC blood thinners could potentially help you if you’re having an ischemic stroke, that’s a gamble you shouldn’t take. Instead, call 911 immediately and wait for professional diagnosis and treatment. (Find out why you should never drive if you suspect you’re having a stroke.)
That said, if you’re at a high risk of an ischemic stroke, or have previously had an ischemic stroke, your doctor may advise you to take low-dose aspirin daily to prevent another stroke. “Aspirin therapy” has been shown to reduce the risk of ischemic stroke (but not hemorrhagic stroke), according to the American Stroke Association.
On the other hand, if you’re having symptoms of a heart attack, aspirin may help. That’s because heart attacks are only caused by blood clots in the heart—not hemorrhaging. Call 911 first, and your operator may advise you to take an aspirin while waiting for paramedics.
The American Heart Association recommends people who are at a high risk of heart attack or who have previously survived a heart attack to take a daily low-dose of aspirin to prevent a heart attack. But never begin aspirin therapy without first talking to your doctor.
The best prevention for heart attack and stroke? Check out these tips by doctors.