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New Study: Is daily aspirin good for you?

Robin Wulffson MD's picture
aspirin, heart attack, stroke, gastrointestinal bleed, cancer, preventive health

LONDON, ENGLAND - About 30% of middle-aged adults in the U.S. regularly take an aspirin with the hope that it will lower their risk of suffering a heart attack or stroke. However, a new study has found that an aspirin regimen is not for everyone; for some individuals, it can do more harm than good.

Researchers in the Cardiovascular Sciences Research Center at St. George’s, University of London conducted a meta-analysis of nine randomized trials and published their findings online on January 9 in the Archives of Internal Medicine. (A meta-analysis is a compilation of similar studies to increase validation of results.)

The researchers analyzed nine randomized studies of aspirin use in the Europe, Japan, and the United States, Europe and Japan, which comprised more than 100,000 subjects. The study participants had never had a heart attack or stroke. The all regularly took aspirin or a placebo to determine whether aspirin benefits individuals without documented heart disease.

With the meta-analysis, the investigators found that regular aspirin users were 10% less likely than non-users to have any type of heart event, and 20% less likely to have a nonfatal heart attack. While that finding revealed the benefits of an aspirin regimen, the study also found that the risks of regular aspirin ingestion outweighed the benefits for this group of individuals with no history of heart disease.

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The researcher reported that regular aspirin users were about 30% more likely to have a serious gastrointestinal (GI) bleeding event, a side-effect of regular aspirin use. Furthermore, the overall risk of dying during the study was similar between aspirin users and non-users. Some studies have reported that an aspirin regimen might reduce the risk of cancer; however, this study found no reduction in the risk of cancer among the aspirin users.

Over all, for every 162 people who took aspirin, the medication prevented one nonfatal heart attack; however, it was linked to two serious GI bleeding episodes. “We have been able to show quite convincingly that in people without a previous heart attack or stroke, regular use of aspirin may be more harmful than it is beneficial,” said lead author Dr. Sreenivasa Seshasai. He added that their findings are likely to add to the confusion about who should regularly take aspirin and who should not.

For those that have suffered a heart attack, an aspirin regimen is more beneficial than harmful. Studies have reported that among men who have had a heart attack, regular aspirin use can be lifesaving, lowering the risk of a second heart attack by 20-30%. It also reduces the risk of a recurrence of a stroke for both men and women whose stroke was caused by a blood clot.

Aspirin works by reducing the blood’s clotting function. In blood vessels narrowed by heart disease, clots are prone to form, which block the flow of blood beyond that point. If a clot forms in a coronary artery, a heart attack can occur; if it occurs in a blood vessel of the brain, a stroke can occur. Thus, an aspirin regimen can reduce the risk of either.

In 2007, the U.S. Agency for Healthcare Research and Quality reported that 19% of Americans regularly took aspirin, including 27% of those ages 45 to 64 and about 50% of those 65 and older. However, the study also noted that many current aspirin users have never had a heart attack or stroke, and take aspirin in the hope of preventing one. Among middle-aged aspirin users, it found that 23% did not have established heart disease. Among older aspirin users, 41% did not have a history of heart disease or stroke.

Take home message: Although aspirin is readily available over the counter, remember that it is a drug and all drugs have a risk of side-effects. For individuals with a history (or family history) of heart disease or blood clots, the benefits of aspirin outweigh the risks for most. In addition, if you are on an aspirin regimen or are considering beginning one, it is prudent to discuss the pros and cons with a healthcare professional,