Aspirin has been around for so long that its easy to forget it is a powerful drug. In addition to relieving pain, it helps prevent blood platelets from sticking together. Thats why its often valuable in preventing a clot-induced heart attack or stroke. Whether or not you should use aspirin for cardiovascular prevention requires weighing the benefits against the risks. This hasnt been easy. "Multiple studies have shown the risk/benefit ratio can be affected by age, gender, diabetes, blood pressure, cholesterol and smoking, in addition to history of any kind of bleeding, especially gastrointestinal and intracranial," says Cleveland Clinic cardiologist Leslie Cho, MD.