Tip/Thought of the Day

An Aspirin A Day Is Not For Everyone

Long before aspirin tablets were developed by Bayer Pharmaceuticals in Germany, people in ancient Egypt chewed willow bark to relieve inflammation and pain. Later, Hippocrates, (a Greek physician after which the Hippocratic oath, which all doctors pledge, was named), also recorded the benefits of willow bark and leaves. Now we know that aspirin (or acetylsalicylic acid- ASA) which is derived from willow trees, can help prevent heart attacks, potentially ward off risk factors that lead to cancer, on top of the benefits of fever and inflammation reduction.

Aspirin is a non-steroidal anti-inflammatory drug (NSAID), which are medications with the following effects:

  • Analgesic: Relieves pain without anesthesia or loss of consciousness
  • Antipyretic: Reduces a fever
  • Anti-inflammatory: Lowers inflammation when used in higher doses

Initially aspirin was a much needed reprieve from pain for patients with arthritis. But the high dosages needed to achieve the benefit often produced significant side effects of gastro-intestinal upset and bleeding. That’s why other medications, such as Motrin and Aleve were developed. Both have the same potential side effects, but far lower doses are needed to get the anti-inflammatory and analgesic effects.  

Because of GI issues and anti-coagulant effects, aspirin and other NSAIDS should not be taken by anyone who’s prescribed a blood thinning agent such as Warfarin, Pradaxa, Exralto, or has a history of an ulcer, liver disease, or indigestion unless directed by your healthcare provider.

One of the first drugs to come into common usage, aspirin is still one of the most researched drugs in the world, with an estimated 700 to 1,000 clinical trials conducted each year.  Despite being a commonly used medication, continued trials are crucial to further understand how drugs interact with each other, and to unearth previously unknown health risks and benefits that may arise when used.

By the 1990’ s, a new study showed that aspirin helped reduce clotting; people with a high risk of blood clots, stroke, and heart attack were told to use aspirin long-term, in low doses. It is still often given to patients immediately after a heart attack to prevent further clot formation and cardiac tissue death.

But in 2019, new research, highlighted by the American Heart Association advised against taking daily aspirin (unless under physician supervision), as it can actually cause harm.

“We’re talking about healthy people who don’t have known heart disease or stroke, who might have been considering or already taking an aspirin to prevent that heart attack or stroke in the first place,” said Dr. Erin Michos, one of the writers of new prevention guidelines developed by the American Heart Association and American College of Cardiology.

According to three significant studies published last year and one major analysis released this year that looked at 10 other studies, the benefit from taking a daily low-dose aspirin was offset by the danger of internal bleeding and other side effects in people considered to be at low or moderate risk for heart disease.

The new recommendation doesn’t apply to people who already have had a stroke or heart attack, or who have undergone bypass surgery or a procedure to insert a stent in their coronary arteries. Please speak to your provider if you have any questions about your current aspiring regimen.


The newest recommendation underscores the importance of speaking to your provider before taking any new medicine, even over-the-counter medications, and making sure you provide a complete list of everything you take. Ask if aspirin is right for you. Do not stop or start aspirin without first speaking to your provider- depending on your medical history and risk factors, suddenly eliminating it can lead to serious health concerns.



-Sources:

-medicalnewstoday.com/articles/161255

-cnn.com/2019/07/22/health/aspirin-daily-use-adults-heart-study/index.html

-pharmaceutical-journal.com/news-and-analysis/infographics/a-history-of-aspirin/20066661.article?firstPass=false

-onlinelibrary.wiley.com/doi/full/10.1111/bjh.14520

-ncbi.nlm.nih.gov/pmc/articles/PMC1119266/

-ncbi.nlm.nih.gov/pubmed/30391545

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