An Aspirin a Day: Will it Help or Hurt?

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An aspirin a day may help those likely to have a stroke or heart attack, but for most others it may be unhelpful or even harmful, according to a growing pile of studies.

For years, taking a daily low dose of aspirin to guard against stroke or heart attack was considered sound advice and millions of people followed it. In 2007, nearly 20% of US adults reported taking baby aspirin regularly, with almost 50% of those 65 and older taking it.

But in recent years, that assumption has crumbled in the face of numerous studies.  Evidence continues to mount that daily aspirin therapy is not suitable for most, and should only be used in those with certain medical conditions.

Cheap and effective, regular strength aspirin has traditionally been used as a safe and proven treatment to relieve pain, inflammation, and fever as needed. The basis for aspirin, found in willow tree bark, was used by ancient civilizations thousands of years ago for its benefits, and has been extensively studied and used ever since.

Aspirin can be a lifesaver for those who have heart issues or are at risk of stroke, says Dr. Keith Lamy, at Austin family practice diagnostic center.

Popping an aspirin shortly after a heart attack decreases your chance of dying.

Aspirin can stop the blood clots that can cause heart attacks and strokes. Clots are clumps of blood that form inside your blood vessels.  They are useful when they form after an injury because they plug the damaged vessel and stop bleeding.  But other clots that don’t dissolve can block a vessel and stop blood flow to your heart or brain.

When you take an aspirin it prevents clotting, which can make it less likely you will suffer a heart attack or stroke.

But it can also hurt your body if you have certain stomach and bleeding conditions.  Aspirin can cause ulcers and stomach upset and bleeding.  It’s especially problematic for people who are prone to bleeding or are on blood thinning or other medications.  It’s also not a good idea for people who have kidney failure or severe liver disease.

And even though aspirin can help stop a stroke caused by a clot, it may actually increase your chance of having another type of bleeding stroke.

Determining who will most benefit from aspirin is still under extensive study.  And the latest guidance can be somewhat difficult to interpret.

The US Preventive Services Task Force recommends low-dose aspirin to prevent cardiovascular disease and colorectal cancer if you are age 50 to 59 years with no bleeding issues and have a 10% or greater risk of heart disease within the next ten years.  You should plan to take aspirin for at least a decade.

For all others,  there just isn’t enough evidence to recommend taking baby aspirin for heart disease and colorectal cancer, the task force said. Adults should consult with their doctors and decide for themselves if it is worth the risk.

It’s safe to say that we are still trying to understand what aspirin can do for our bodies, with research continuing to determine how best to use the drug.

Aspirin has been studied as a possible therapy for cancer,  dementia, and many other conditions.  Some evidence supports using aspirin to slightly reduce the risk of breast, prostate and endometrial cancer, but the strongest case is for prevention of colorectal cancer when aspirin is taken for many years.

If you believe you may benefit from aspirin because of heart or stroke risk, you should consult with your doctor to see whether taking it is worth the risks.

If you do initiate aspirin therapy, it’s wise to limit or stop your alcohol use, because drinking while taking aspirin can result in liver damage and stomach bleeding.  If you have surgery, you should tell your doctor or dentist because your regular use of aspirin may cause you to bleed more during your procedure.

You should also not suddenly stop taking aspirin without consulting your doctor.   Discontinuing aspirin therapy can cause a rebound effect that could actually increase your chance of having a heart attack, especially if you’ve already had one. 

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