A lot of people include a daily aspirin in their well-being regimen, alongside prescription medications and supplements. We asked Jennifer Sposito, PharmD, BCPS, Clinical Pharmacist, Parkview Regional Medical Center, to explain the benefits, the risks, and exactly who should be taking this over-the-counter option.
How does aspirin work?
Aspirin works by preventing blood clots from forming. Blood clots in the body may cause a stroke or heart attack by blocking blood and oxygen supplies to the brain or heart. Stroke and heart attack are serious health events, which may lead to a decreased quality of life or even death.
Side effects and risks.
Like all other medications, aspirin has both health benefits and risks. Some people tolerate a low-dose aspirin without issue, but others may notice upset stomach or heartburn. These side effects can often be managed by taking aspirin with food. But, if the pain and discomfort is severe or worsens, it may indicate a more serious side effect, like a stomach ulcer. This should be managed as directed by your doctor.
Another worrisome side effect of aspirin is the increased risk of bleeding. This can range from minor cuts and bruises that take longer to heal, to bleeding in the stomach or intestines, to even bleeding in the brain (hemorrhagic stroke). Daily aspirin is generally not recommended in patients already at a high risk of serious bleeds.
The risk of side effects may be increased when aspirin is combined with other prescription or over-the-counter medications, herbal supplements, vitamins or alcohol. It is also important to note that patients should not take aspirin if they are allergic to aspirin or its inactive ingredients.
Recommendations.
In April 2016, the United States Preventative Services Taskforce released a statement following an extensive review of research.[1] The Taskforce recommends that patients between the ages of 50 and 69, with a high risk of cardiovascular disease and a low risk for bleeding take a daily, low-dose (81 mg, “baby aspirin”) aspirin to prevent heart attack or stroke.
Risk of cardiovascular disease is determined by your doctor and based on:
• Age
• Sex
• Race
• Cholesterol and blood pressure
• History of diabetes and smoking
The American Heart Association® (AHA) saw similar results and suggests that patients with a high risk of heart attack take a low-dose aspirin, if their doctor recommends it.[2] The AHA also suggested that patients who have survived a heart attack take a low-dose aspirin.
Both the U.S. Preventative Service Taskforce and the AHA stress the importance of speaking with your doctor prior to starting aspirin therapy to be sure a daily aspirin is right for you.
Who should take aspirin?
There is no easy way to answer this question. For some patients with a low risk of developing serious bleeds, the prevention of stroke or heart attack may mean aspirin should be included in their daily medicines. For other patients, the risks of aspirin may be greater than the benefits it may offer. In the end, the decision to take a daily, low-dose aspirin is one that should be made with the help of a physician familiar with your past and present medical conditions.
References
1. Final Recommendation Statement: Aspirin Use to Prevent Cardiovascular Disease and Colorectal Cancer: Preventive Medication. U.S. Preventive Services Task Force. September 2017. https://www.uspreventiveservicestaskforce.org/Page/Document/RecommendationStatementFinal/aspirin-to-prevent-cardiovascular-disease-and-cancer
2. Aspirin and Heart Disease: American Heart Association. March 2017. http://www.heart.org/HEARTORG/Conditions/HeartAttack/PreventionTreatmentofHeartAttack/Aspirin-and-Heart-Disease_UCM_321714_Article.jsp#
