Should I be taking a daily Aspirin?

Data from ongoing research has suggested that the daily use of aspirin is beneficial for protecting against heart attacks, strokes, certain cancers, and possibly treatment for neurodegenerative diseases such as Parkinson’s and Alzheimer’s. With this in mind, should all adults be taking a daily aspirin.  

In September 2015, the U.S. Preventative Services Task Force released new guidelines recommending aspirin to protect against heart disease and colorectal cancer. However, the guidelines are intended for those ages 50 to 69 with an increased risk of heart attacks or strokes and are not at increased risk for bleeding.

To understand why someone should or should not take daily aspiring requires a good understanding of how this drug truly works.  Aspirin is a synthetic compound derived from an ingredient found within the bark of a willow tree.  Aspirin helps reduce fever, pain, and inflammation in the body and stops platelets from sticking together and forming clots. When blood platelets are able to clump together, a clot can form a block an artery causing decreased blood flow to the heart or brain leading to a heart attack or a stroke. The obvious benefit of aspirin is that is minimizes these potential risks. However, there is a downside to this. Normally when we cut ourselves the platelets clump together at the site and form a plug to prevent blood loss. This can lead to increased bleeding amongst those who use aspirin. Aspirin also carries the risk of increased stomach ulcers and gastrointestinal bleeding especially in older patients. While aspirin can help prevent against an ischemic stroke, the risk of a hemorrhagic stroke (bleeding) that may occur from a fall and hitting your head is increased.  Tinnitus (ringing in the ears) and asthma can also occur in some who take aspiring.

A survey of over 2500 adults in the U.S. aged 45 to 75 years old published in the American Journal of Preventative Medicine (2015) showed that over 52% of respondents were taking aspirin. Of those surveyed without a history of cardiovascular disease, 47% were taking aspiring daily.

In considering risks and benefits, the daily use of aspirin for those who have had a prior heart attack, stroke, or TIA is often recommended by physicians to prevent a second episode.  Others middle aged adults who have not had aheart attack or stroke may still benefit from daily aspirin use if they have personal risk factors for or a strong family history of cardiovascular disease, stroke, or diabetes.

So where does the rest of the population fit in with regards to taking aspirin? The evidence for primary prevention of a first heart attack or stroke is still not clear cut. Research appears to be pointing to including daily aspirin use in some disease prevention and treatment guidelines, but caution still remains.  The risks of use may outweigh the potential benefits in healthy individuals with little or no risk factors.

Aspirin should not be taken unless directed by a physician.

References:

Williams CD, Chan AT, Elman MR et al. Aspirin use among adults in the U.S.: results of a national survey. American Journal of Preventative Medicine. 2015 May; 48(5): 501-508.

U.S

Preventative Task Force Aspirin for the prevention of cardiovascular disease http://www.uspreventiveservicestaskforce.org/Page/Document/UpdateSummaryFinal/aspirin-for-the-prevention-of-cardiovascular-disease-preventive-medication