Trump takes a higher aspirin dose daily than what doctors recommend: Is it safe for the heart?

US President Donald Trump says he is in “perfect” health because he takes more aspirin than doctors recommend, uses makeup to cover bruising on his hands and does not get regular exercise because he finds it “boring.”

In an interview to The Wall Street Journal, Trump said he had been taking larger than recommended doses of aspirin for the last 25 years, even as he said it caused him to bruise easily. “They say aspirin is good for thinning out the blood, and I don’t want thick blood pouring through my heart,” Trump said. He takes 325 mg of aspirin per day, rather than the 81 mg dose sometimes recommended by doctors. “They’d rather have me take the smaller one,” he adds.

But is taking extra aspirin safe at all? “Low-dose aspirin is commonly prescribed to reduce the risk of heart attack and stroke in selected patients by preventing blood clots. However, when aspirin is taken in doses higher than recommended, either intentionally or accidentally, it can have important and sometimes serious effects on the body. Extra aspirin does not mean extra heart protection, and in some cases it can do more harm than good,” says Dr Vanita Arora, cardiac electrophysiologist and interventional cardiologist, Indraprastha Apollo Hospital, New Delhi.

At therapeutic low doses (usually 75–150 mg per day), aspirin works by inhibiting platelet aggregation, which helps prevent clot formation in arteries supplying the heart and brain. Doctors commonly prescribe a low daily dose for people who already have heart disease, and a one-time higher dose during a suspected heart attack.

Importantly, the beneficial effect of aspirin on clot prevention reaches its maximum at relatively low doses. Once that effect is achieved, taking more aspirin does not further protect the heart.

Higher doses, however, have additional effects on multiple organ systems. While aspirin also has pain-relieving, fever-reducing and anti-inflammatory properties, increasing the dose does not always increase benefit and often raises the risk of harm.

The most serious side effect is bleeding. Aspirin interferes with the body’s ability to stop bleeding, and higher or repeated extra doses raise the chances of bleeding in the stomach or intestines and more rarely but more dangerously, in the brain. This risk becomes greater with age, alcohol use, dehydration, or when aspirin is combined with other blood-thinning medications.

The stomach is particularly vulnerable. Aspirin can irritate the stomach lining, and extra doses can lead to gastritis, ulcers, abdominal pain and bleeding. Symptoms may include black or tarry stools, vomiting blood, easy bruising, or prolonged bleeding from minor cuts. People with a history of stomach ulcers, those who consume alcohol regularly, or those taking other blood-thinning medicines are at high risk. Over time, repeated high dosing may cause erosions or ulcers in the stomach or small intestine.

In some people, especially older adults, higher doses can also strain the kidneys, particularly if the person is dehydrated or already has kidney or heart problems.

At very high levels, aspirin can even become toxic, causing symptoms such as ringing in the ears, rapid breathing, or confusion — conditions that require urgent medical attention.

While a single extra dose is unlikely to cause immediate harm for most people, regularly increasing the dose without medical advice is risky.

Rush to the hospital. If the person has already been told by a doctor that they can take aspirin for heart emergencies, they may be advised to chew one regular-strength aspirin (usually 325 mg) while waiting for help. Chewing allows it to work faster. However, aspirin should not be taken if the person is allergic to it, has active bleeding, or has been told by a doctor to avoid it. Remember aspirin is not a substitute for emergency care and does not stop a heart attack on its own. Always follow the dose prescribed by your cardiologist. Aspirin is a valuable medicine when used appropriately.