Should You Take a Daily Low-Dose Aspirin?
Your primary care doctors at Cohen Medical Associates in Delray Beach, Florida would like to discuss with you a common question we get at the office. Should you take a daily low-dose aspirin? Many doctors are proponents of a daily 81 milligram dose of aspirin for those who’ve already had a heart attack in order to prevent another one. But for years, many physicians have recommended that their patients who are at risk of a heart attack or stroke also take a low-dose aspirin tablet or fish oil supplements to prevent the first incident.
Different studies have reached differing conclusions on the benefits of aspirin use.
For example, a 2016 study conducted by a medical team at the University of Southern California (USC) concluded that 81 mg. of aspirin daily reduces the death rate from heart disease by 22 percent. This effect was most pronounced in people aged 50 and over. The study recommended that adults ages 50 to 59 who have a cardiovascular risk above 10 percent with a life expectancy greater than 10 years should take a low-dose aspirin every day, assuming they aren’t at increased risk for bleeding.
Now come two new studies which found: that taking a daily aspirin for those who have not had a heart attack does not confer sufficient heart-attack prevention benefits when weighed against the risk of internal bleeding; that taking a daily aspirin did not lower heart-attack risk enough to offset the risks of bleeding in those with diabetes; and, that fish-oil supplements didn’t help prevent a future heart attack.
In the first study, at Brigham and Women’s Hospital in Boston, researchers gave either an aspirin or a placebo to 12,456 people who were thought to be in the moderate-risk category for a possible future heart attack due to other health issues such as smoking or obesity.
After five years, four percent of each cohort had experienced a heart problem, which was lower than expected, given their health histories. Study leader, Dr. J. Michael Gaziano, surmised that these people were actually at low-risk of heart disease, or that other drugs they were taking to lower blood pressure and cholesterol may have cut their risk more than the aspirin. One percent of this group experienced mostly mild stomach or intestinal bleeding, as well as more nosebleeds, indigestion, reflux, or abdominal pain than the control group.
The second study, involving diabetics, took place at the University of Oxford. Those with diabetes are at higher risk of heart problems and blood clot-induced strokes, as well as serious bleeding. Researchers gave 15,480 adults with Type 1 or Type 2 diabetes either one 100 mg. aspirin, one gram of fish oil, or both, or placebos every day. After more than seven years, there were fewer heart issues among the aspirin users but more cases of severe bleeding. There was no difference in heart attack or stroke rates in the group taking fish oil supplements.
Researchers in both studies concluded that the possible benefits accruing from daily aspirin use outweighed the increased risk of serious bleeding incidents, especially among diabetics, and that fish oil supplements were worthless. The European Society of Cardiology, however, headlined its press release on the Boston study: “Jury still out on aspirin a day to prevent heart attack and stroke.”
So what to make of these competing studies and conclusions?
Lesson #1: The best way to prevent heart attacks and strokes is through daily exercise and a healthy diet, including lean meat, fish, nuts, fruits, and vegetables.
Lesson #2: Many people wrongly assume that because something is available over the counter (OTC), that means it’s safe. Many OTC drugs were once available only by prescription, meaning they are not necessarily “harmless.” All have some side effects that can affect some people and not others.
Lesson #3: Check with us before beginning any OTC drug or supplement. Our doctors are not only current with all the latest medical research and recommendations, we are also familiar with your medical history and current health condition. We can help you decide the best course of action to keep you in optimal health.