Aspirin can be a life saver as it helps to reduce the risk of further heart attacks for people who have suffered one and also minimizes the risk of certain cancers. These findings were published in the PLOS ONE journal by researchers led by Dr. David Angus at the University of South California (Keck School of Medicine). Various criteria were taken into account for the purpose of the study including the referring to databases on cancer incidence, body mass index, and the functionality of people as they age. One of the findings was that more extensive usage of aspirin could save hundreds of thousands of lives and a huge $692 billion in health care costs.
Aspirin can help prevent a heart attack by reducing blood clotting. The blood’s clotting cells, called platelets, build up at the site of a wound to form a plug that seals the opening in blood vessels, thereby stopping bleeding. This however can have a detrimental effect on the heart, particularly if the blood vessels are already narrowed from artherosclerosis, the building up of fatty deposits in the arteries. If these fatty deposits burst and a blood clot is formed, blood flow to the heart might be further restricted which can lead to a heart attack. Aspirin reduces the clotting in these situations, thereby reducing the risk.
One area of controversy however is whether healthy people should be using aspirin as a preventative against an initial heart attack, stroke, cancer, or other health problem. Aspirin has potent anti-inflammatory properties and researchers believe it can reduce the inflammation that can induce a heart attack and mitigate the growth of cancerous tumors that also thrive in such situations. Many doctors recommend that high-risk people should take a low dose of aspirin (typically 80 mg) every day. In 2014 however the Food and Drug Administration (FDA) postulated that preventative dosages in people who were not in the high risk category produced more risk. The anti-inflammatory agent in aspirin can activate enzymes that can cause ulcers and bleeding by aggravating stomach and intestinal tissues. They therefore reasoned the risk of these kind of side effects for people who had not had a first heart attack were too great compared to any possible benefit gained.
The FDA’s stance was also supported in part by the American Heart Association (AHA) and the U.S. Preventative Services Task Force (USPSTF). The difference in their approach is that they continue to recommend the medication for people who may not have had a heart attack but are at a higher risk of getting one. This risk factor is determined by evaluating an individual’s specific risk of developing heart disease within a 10 year time frame, based on factors like age, family history of heart trouble, blood pressure, and cholesterol levels. Forty percent of men and ten percent of women who come into this bracket however are not taking aspirin according to the PLOS ONE journal study. The team concluded that if everyone who came into this higher risk category were to take the drug, there would be 900,000 more people alive by 2036. This is because 11 cases of heart diseases and 4 cases of cancer would be prevented for every 1,000 people.
Dr. Angus and the team also considered the question of whether people over age 50 should start taking daily low-dose aspirin to prolong their lives and weighed it against the side effects of intestinal bleeding. Their conclusion was that those who fell into the higher risk category and met recommended criteria for taking aspirin should do so because the benefits counted for more than the negatives. The team, in effect, promoted the AHA and USPSTF viewpoint which recommends people discussing their individual risk and benefit ratio with their doctor rather than ruling out the drug all together. As Dr. Angus explained it, “The role of the physician is to explain the risk and benefit and together with the patient make a decision.”
Doctors may recommend aspirin for people suffering from certain coronary conditions which include having stents, having undergone coronary bypass surgery, or suffering from chest pain due to coronary artery disease (angina). They may also do so for people who suffer from diabetes and who have at least one other heart disease risk factor such as smoking or high blood pressure. Age can also be a factor for men older than 50 and women older than 60. The strength of the daily dosage prescribed by doctors can vary from 80 mg (low adult dose) to 325 mg (regular dose). From the patients’ side, any history of bleeding or clotting disorders, aspirin allergy (which can lead to asthma for example) and bleeding stomach ulcers should be revealed to their doctors.
One other important factor to be taken into account is stopping daily aspirin therapy for patients who have been doing it for a while in consultation with their doctors. This can have a rebound effect and increase the risk of a heart attack in certain situations, e.g. for people who have already had a heart attack or have had a stent placed in one or more of their heart arteries. Blood clots may be triggered in these situations which can be dangerous for the heart as discussed above.