TV advertisements, magazine articles and over-the-fence chats between neighbors about the benefits of aspirin have led some people to take an aspirin everyday because they think it will protect them from a heart attack or stroke. Some people take aspirin everyday for headaches or for life’s aches and pains. Since the daily use of aspirin carries some very serious health risks that people may not be aware of, it’s important to get the facts.Heart attacks result from the stoppage of blood flow to the heart when a coronary artery becomes plugged from a blood clot (known as a thromboembolism), from an embolism made of fatty plaque or from arterial spasm. There are two kinds of strokes. Occlusive strokes result from thromboembolic blockage of an artery supplying the brain. Hemorrhagic strokes result from bleeding within the brain due to rupture of a brain blood vessel. Aspirin is effective at reducing blood clot formation within arteries. Thus aspirin reduces the risk of thromboembolic heart attacks and occlusive strokes but not hemorrhagic strokes. Taking daily aspirin can actually increase the risk of hemorrhagic strokes.
According to the Mayo Clinic daily aspirin therapy can prevent a first or second heart attack and reduce the risk of heart disease in men of all ages. The Mayo Clinic says daily aspirin therapy can prevent a first stroke, prevent a second heart attack and reduce the risk of heart disease in women under age 65. For women over age 65 it can prevent a first and second heart attack, prevent a first stroke and reduce the risk of heart disease. The safest daily dose is between 75 mg and 81 mg (baby aspirin). In some cases your doctor may recommend a higher dose up to 325 mg per day.
Aspirin therapy is associated with a great many health risks including internal bleeding. The Mayo Clinic recommends that you refrain from aspirin therapy if you have a bleeding or clotting disorder, asthma, stomach ulcers or heart failure. For whom does the Mayo Clinic recommend daily aspirin therapy? For those people who have already had a heart attack or stroke; and for those people who have strong risk factors for a heart attack or stroke.
Risk factors for blockage of arteries going to the heart or brain from blood clot formation include: smoking tobacco; high blood pressure (systolic pressure at or over 140 mm Hg or diastolic pressure at or over 90 mm Hg); total cholesterol level at or over 240 mg/dL; low density (bad) cholesterol level at or over 130 mg/dL; sedentary life style without exercise; diabetes; chronic stress; having two or more alcoholic drinks per day if you’re a man and one or more drinks a day if you’re a woman; and a family history of heart attacks or strokes.
What are the chief health risks of daily aspirin therapy? The Mayo Clinic says they include hemorrhagic stroke (bleeding stroke); gastrointestinal bleeding; allergic reaction; and ringing in the ears (tinnitus) with hearing loss. Since aspirin can upset the stomach and thin the blood they warn against having more than one drink a day if you’re a woman and more than two if you’re a man. Bleeding risk is increased in patients taking a daily aspirin if they’re already taking a blood thinner, if they use NSAIDs or corticosteroids regularly or if they take certain supplements like Sanshen, Dong quai, Evening primrose oil; Gingko biloba; Policosanol; and Willow bark.
In May 2010 Dr. Andrew Hart of the University of East Anglia presented research at the Digestive Disease Week conference in New Orleans indicating that regular use of aspirin for one year or more increases the risk of developing Crohn’s Disease by five times. Crohn’s Disease involves inflammation and swelling of any part of the digestive system, but most often the lower section of the small intestine called the ileum. It can be debilitating because of chronic abdominal pain, diarrhea, rectal bleeding and weight loss. Crohn’s Disease can require lifelong medication. Dr. Hart’s research group followed 200,000 volunteers aged 30-74 in the UK, Sweden, Denmark, Germany and Italy who had been recruited for a European study on the link between cancer and nutrition. Although all volunteers were initially well, a small number had developed Crohn’s Disease by 2004. When study participants were questioned about their use of aspirin, it turned out that the regular aspirin users were five times more likely to be in the group that developed Crohn’s Disease.
The take home message is that while daily aspirin therapy can be very beneficial, even life saving, in preventing heart attacks and occlusive strokes in some people, it does carry some very significant health risks. No one should start aspirin therapy without their doctor’s approval after reviewing the potential benefits and risks. Anyone taking a daily aspirin should check in with their doctor if they notice symptoms of gastrointestinal inflammation such as abdominal pain, diarrhea or rectal bleeding.
Tags: Heart Attack Prevention