Daily Aspirin help or hazard?

If you are taking a low dose aspirin on a daily basis to prevent heart problems, it seems that it does not offer protection but in fact might be harmful.A recent study reported in the Lancet showed that in people taking aspirin on that basis have very marginal protection than if they took nothing at all. The study focused on people who had no history of cardiac disease – the ones most targeted by previous information – and that their rate of occurrence of heart attack, strokes and death from heart disease was reduced to 0.51% per year. This sounds OK, until you see that the control group who took no aspirin had a rate of occurrence from the same conditions of 0.57%.

The benefit therefore is small, but there is a corresponding rise in the rate of major gastrointestinal and extracranial bleeding. This went up from 0.07% a year to 0.10% among the aspirin group, and showed that the risk of such bleeds rose along with their cardiovascular risk level.

The study analysed results for 95,000 people who took part in long-term primary prevention trials and has made the study’s authors speak out about the need to review the current guidelines for patients looking to lower their risk of heart disease.

Dr. Baigent, the main study author, recommends that to prevent heart disease we go back to basics. Primary prevention with aspirin could be expected to prevent five nonfatal heart attacks but cause three extra gastrointestinal bleeds and one extra intracranial hemorrhage per 10,000 people treated per year, To avoid these incidents the advice is to stop smoking, and to lower blood pressure and cholesterol levels through diet and exercise. His last word on the subject,” The benefits of adding aspirin clearly outweigh the hazards.”

BUT ..

Researchers never do seem to agree with each other, and a study at the University Medical Centre Utrecht in the Netherlands came to a similar, but different, conclusion. They used the same research data to analyse and agreed that the risk of aspirin was not acceptable in people who took it purely as a preventive but that there were significant gender and baseline risk factors to take into account. They recommended that a low dose daily aspirin was justified for the following groups:

** Men age 50 to 59 who are at five times the average cardiovascular risk
** Men age 60 to 69, who have at least twice the average cardiovascular risk
** Women in the same age range with at least five times the average risk
** All men age 70 to 79 regardless of risk
** Women in the same age range with at least double the average risk

SO?
As ever, you have to look at your own potential risk for heart disease and I would suggest you put all the lifestyle factors of diet and exercise in place and discuss this with your doctor before starting, or stopping, a daily aspirin habit.

Yet another difference between men and women

Well apart from the obvious ones we all know about; that men need more of the duvet and don’t eat as much as chocolate, it seems our aspirin response is different too. A daily aspirin for those men over 45 and women over 55 is often recommended as a preventive for heart attacks, but it seems that the benefit differs by gender.

Men do get fewer heart attacks with a daily dose, but it doesn’t affect women in the same way. Their benefit lies in the fact it reduces the risk of stroke, not of heart attacks.

New research published this month in the Annals of Internal Medicine has also focused on the possible dangers of regular aspirin use in causing gastrointestinal bleeding. This risk gets higher as the dose increases and the new recommendation is that no more than 75mg a day is just as effective as higher amounts. If you already have heart disease then taking 100mg or more of aspirin a day will not be of any benefit for the existing condition.