Does an Aspirin a Day Keep the Doctor Away?

Does an Aspirin a Day Keep the Doctor Away?

Aspirin has been reported to help lower the risk of heart attack and clot-related strokes, but the latest research suggests that may not be true for most of us.

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Examine the label on a bottle of aspirin and you'll quickly find out all it is capable of doing: it can reduce fever, pain and inflammation from things like muscle aches, toothaches, the common cold and headaches.

Read more about NSAIDs Basics.

But what you won't find on the label is aspirin's other claim: that it can help lower the risk of heart attack and clot-related strokes. Millions of people worldwide take a daily low-dose aspirin hoping to reap that benefit. Though the mechanism is not completely understood, it's known that aspirin, because it's an antiplatelet drug, may reduce platelet clumping, which contributes to blockage in blood vessels.

But a new study might be changing the decision to take that daily dose.

As reported by CNN and many other news outlets, taking aspirin every day had no significant health benefits for healthy older adults. In fact, it might even cause serious harm.

Three studies, published in the New England Journal of Medicine, uncovered some significant, unsettling and serious findings.

In the largest study, a double-blind, placebo-controlled trial of 20,000 participants in Australia and the United States, the group taking the aspirin did not have a higher rate of "disability-free survival," and they were not free of complications. Instead, they had a higher risk of major hemorrhage than did the placebo group (the group that didn't take any aspirin).

To put that into layman's terms, people who took a daily low-dose aspirin did not live longer and had a higher risk of internal bleeding, either in the upper gastrointestinal tract (the esophagus, stomach and upper part of the intestine) or in the brain.

The third finding from the study was unexpected and "should be interpreted with caution," according to the study's authors: the aspirin-taking group's higher risk of death was due primarily to cancer.

As is true of so many studies, these results are not cut-and-dried. There are many if, ands or buts.

CNN says that, "According to these three new studies … taking a low-dose aspirin daily is, at best, a waste of money for healthy older adults. At worst, it may raise their risk of internal bleeding and early death."

But for some, the benefits may outweigh the risks, particularly people who have had a heart attack or stroke. The U.S. Preventive Services Task Force also recommends a daily low-dose aspirin if you're between 50 and 59 and:

  • Have a 10 percent or greater risk of cardiovascular disease;

  • Are not at increased risk for bleeding;

  • Have a life expectancy of at least 10 years; and

  • Are willing to take low-dose aspirin daily for at least 10 years.

For this group, it says low-dose aspirin can help prevent cardiovascular disease and colorectal cancer. Its recommendation for adults over 60 is less definitive.

So, what if you're healthy and taking a daily dose of aspirin? Should you stop? Not necessarily, say the researchers. Always consult your health care professional before stopping or staring any medication, they say.

Aspirin, as we know it, has been around since the 1890s, when scientists at Bayer discovered a way to synthesize acetylsalicylic acid and make it less irritating. But its key ingredient and natural equivalent had been used way before that, as far back as the time of the Greek physician Hippocrates, who wrote that willow leaves and bark helped reduce body temperature and inflammation. Acetylsalicylic acid is also found in jasmine, peas, beans, clover and some grasses and trees.

Although it's "natural," aspirin shouldn't be taken lightly. It's hardly harmless. If you do take it, here are some things to know:

  • Even though it's sold over the counter, aspirin is a drug and can interact with other products and have side effects (which increase with each new product you use).

  • Do not take aspirin regularly without the guidance of a health professional.

  • Make sure to discuss other products you're taking, including prescriptions, over-the-counter medicines, dietary supplements, vitamins and herbs (even if you only take them occasionally). For example, let your health care professional know if you're already taking a medication to thin your blood or if you're taking a dietary supplement, some of which can act as blood thinners.

  • Be aware that taking aspirin with alcohol or other products containing aspirin (like a cough-sinus drug) increases the chances of side effects.

There are no directions on the label for taking aspirin to reduce cardiovascular disease, so make sure you follow the directions of your health care professional.

Generally, you should not take aspirin if you have asthma, uncontrolled high blood pressure, severe liver or kidney disease, bleeding disorders or are allergic to aspirin or other salicylates.

Some common side effects of aspirin can include rash, gastrointestinal ulcerations, abdominal pain, upset stomach, heartburn, drowsiness, headache, nausea or gastritis.

Call your health care professional immediately and stop taking aspirin if you experience any of the following:

  • Ringing in your ears

  • Confusion or hallucinations

  • Rapid breathing

  • Seizure (convulsions)

  • Bloody or tarry stools

  • Coughing up blood

  • Vomit that looks like coffee grounds

  • Fever that lasts longer than three days

Chewing an aspirin can help inhibit platelets from damaging the heart during a heart attack, but the American Heart Association advises people who think they're having a heart attack to call 911 before doing anything else, including taking an aspirin. They say the operator may then recommend that you take an aspirin or the emergency responders may give it when they arrive. Harvard Medical School says the best dose to take in this instance is the average adult aspirin, which is 325 mg, and the pill should not be coated, which makes it act more slowly.

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