An aspirin a day unadvised

asprin.jpegThere has been a recent trend of people taking aspirin everyday in an effort to stave off possible heart disease. According to local physicians, this was not advisable.

There has long been a school of thought that it is a universally good thing to take a low dose of aspirin every day – this followed research that showed it helped people who’d had a heart attack.

The thinking was, if it is good for them, surely it must be good for people who have not yet had one. In fact, this does not follow. This is because even a low dose of aspirin can cause significant if not lethal bleeding from the lining of the stomach.

In one study, 900 patients taking low-dose aspirin regularly were followed for a year. Forty of them were hospitalised to treat bleeding from the gastrointestinal tract – that’s around 4 per cent. This would not be good news for otherwise healthy people.

But in patients who have a history of coronary artery disease, taking aspirin can help prevent a further heart attack. Indeed, the chances of it helping may well be above 4 per cent. Here we say the risk is worth taking because the benefits are greater.

Exactly the same sort of argument applies to stroke prevention in people who have furred-up arteries leading to the brain and who have suffered mini strokes – the chances of the aspirin preventing a big stroke are greater than the chances of it causing bleeding, and so it is a worthwhile calculated risk.

Many people think taking an enteric-coated aspirin – designed to stop the aspirin dissolving until it passes beyond the stomach – reduces the risk of stomach bleeding, but research has shown these pills make no difference.

When it comes to stopping taking low-dose aspirin, there are no studies, so there is no firm guidance. For otherwise healthy patients I would say just stop, said a local doctor. If any of this applies to you, do talk to your doctor before stopping the aspirin. That’s because some GPs advise low-dose aspirin in patients with a high risk of arterial disease from a build-up of fatty deposits – even though these patients have no history of a heart attack or a mini stroke.

Doctors advised that healthy people with no major problems should stop taking aspirin regularly. They also warned against taking low-dose aspirin to prevent deep vein thrombosis on long-distance flights. The reason for this was that there was no evidence such a strategy prevented clots and there was a far greater chance of causing a stomach haemorrhage.

Aspirin is a good medicine – but only when taken in the right circumstances.

Post published in: Analysis

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