An Aspirin a Day Just May Not Keep the Doctor Away

Millions of Americans take an aspirin a day with the intention of being healthy and decreasing the risk of heart disease, stokes and preventing various cancers.  Recently, experts have been questioning the aspirin-a-day regimen, concerned that this everyday miracle drug can pose serious risks, including bleeding in the brain and stomach.

Aspirin, which has been around for more than 100 years, is a cheap, easy, effective way to control pain and inflammation. In 1989, when a major study revealed that a small dose could reduce the risk of stroke and heart attack by preventing blood clots, doctors began recommending that their older patients take a low dose of aspirin, 81 mg, every day.

The drug’s ability to prevent blood clots is also a double-edged sword. The body’s ability to stop bleeding is what prevents a small cut, for instance, from causing uncontrollable bleeding. While aspirin might keep clots from blocking blood flow to our hearts and brains, it also makes it more likely that we might develop serious internal bleeds, particularly in the stomach.

In March the Journal of the American Medical Association a 10-year study of nearly 30,000 adults ages 50 to 75 without known heart disease found that a daily aspirin didn’t offer any discernible protection. On the contrary, taking a daily aspirin of, 80-160mg, almost doubled the risk of dangerous internal bleeding.

And last year the U.S. Preventive Services Task Force—a panel of medical experts—issued new guidelines for patients, recommending only those at risk for heart attacks or strokes should take a daily aspirin.

Many of the risk factors for heart attacks and strokes—including age, diabetes and smoking—overlap, but there are slight differences. High total cholesterol and high levels of LDL or “bad” cholesterol, for instance, are important predictors of heart attacks.

The most important risk factors for strokes include high blood pressure, certain kinds of irregular heartbeats (known as atrial fibrillation) and a condition known as left ventricular hypertrophy in which some of the heart muscle thickens.

Experts agree that women who have already had strokes and men who have already had heart attacks should absolutely be taking aspirin. The new recommendations suggest aspirin will be most beneficial to: men between 45 and 79 who have a high risk for heart attacks, i.e., men who have hypertension and elevated cholesterol levels, and  women between 55 and 79 who are at high risk for strokes.

Clearly, the benefits of aspirin have to be weighed against the possibility of bleeding, and that’s a conversation that experts say every patient needs to have with his or her doctor.

Bottom Line: An aspirin a day may not harmless.  If you have any questions about the use of aspirin, check with your doctor, eat a healthy diet that is low in fat, exercise regularly, and consider an apple a day instead!

Dr. Neil Baum is a physician on staff at Touro Infirmary.  He can be reached at  (504) 891-8454 or through his website, http://www.neilbaum.com

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