Another Look at Aspirin

For years, we have heard that taking a daily dose of aspirin helps to prevent heart attacks, even in patients with no known heart disease. As reported by Time magazine and others, a recent study sheds some important light on the pros and cons of taking aspirin as well as highlighting which patients might benefit from it.

Before we get to the study’s findings, let’s look at why aspirin helps to prevent heart attacks in the first place. Aspirin works by reducing your body’s natural clotting abilities. A certain amount of clotting is crucial to your body’s functioning. When you cut yourself, for example, the platelets in your blood build up at the site of the wound and essentially form a plug that stops the bleeding. That’s a good thing. However, there is a more sinister aspect of clotting that can happen inside your body. A clot can form inside a blood vessel, which can block the flow of blood. If this happens in a critical vessel, e.g., one that supplies your brain or heart, it can lead to a heart attack or stroke. Therefore, aspirin was thought to reduce the risk of heart attack or stroke by reducing the amount of clotting that goes on inside the blood vessels.

In the recent study, researchers reviewed the data on nine randomized trials and made some surprising findings. While the researchers found that daily aspirin does reduce the risk of heart attack in middle-aged adults without known heart disease, the benefits were modest. Also, aspirin did not reduce the incidence of stroke or fatal heart attacks. More troubling, however, was the finding that taking daily aspirin can have serious side effects that outweigh the benefit. The researchers found that patients who take daily aspirin are at a higher risk of suffering internal bleeding (remember, aspirin reduces clotting) and that patients are more likely to suffer internal bleeding than they are to derive a cardiac benefit from the aspirin. Therefore, the researchers concluded that in patients with no known heart disease, “routine use of aspirin for primary prevention is not warranted and treatment decisions need to be considered on a case-by-case basis.”

Keep in mind that this study involved only patients with no known heart disease. The researchers emphasized that for patients who have already suffered a heart attack or stroke, the evidence is indisputable that aspirin is beneficial. As with all medications, you should check with your doctor before starting or stopping aspirin