The Benefits and Risks of Aspirin Therapy


Aspirin is a white, crystalline compound, which is derived from salicylic acid, and is commonly used in tablet form to relieve pain and reduce fever and inflammation. It is also called acetylsalicylic acid.

This popular tablet earned the moniker “wonder drug” because of its numerous benefits, especially for people with coronary artery disease, stroke, and transient ischemic attack (a temporary interruption of blood flow to the brain), which often serves as a warning for an imminent stroke.

Doctors recommend the daily usage of aspirin to their patients, elucidating that this therapy can help lower the risk of heart attack and stroke. According to medical experts, aspirin interferes with the person`s blood`s clotting action during a heart attack or stroke; thus preventing the devastating effects of these fatal conditions by reducing the clumping action of blood platelets. Besides the drug`s effectiveness against heart attack and stroke, aspirin is also reported to boost the survival rate of people with colon cancer, as published in the Journal of the American Medical Association.

In this study, researchers from Massachusetts General Hospital, Dana-Farber Cancer Institute, and Brigham and Women`s Hospital collectively analyzed the link between aspirin use and survival among 1,279 adults with stage I, II, or III nonmetastatic colorectal cancer, or cancer that had not spread to distant areas.

Participants enrolled in the 1980s prior to their cancer diagnosis and agreed to provide updates to the researchers concerning their health conditions. In June 2008, researchers discovered that study participants who reported aspirin use after being diagnosed with colorectal cancer had a 29% lower risk of colorectal cancer death and a 21% lower risk of overall death, compared to non-aspirin users.

To help lower the risk of heart attack or stroke, doctors recommend the taking of low-dose aspirin (81mg) every day for patients with the following experiences and conditions:

* After a heart attack, to prevent another one.

* By people who have coronary artery disease.

* By people with stable angina.

* By people with unstable angina.

* After bypass surgery or angioplasty.

* By people who have had a stroke or transient ischemic attack (TIA).

* After surgery to prevent a stroke (carotid endarterectomy).

* By healthy men over age 40 who have one or more risk factors for heart disease, as long as their blood pressure is controlled and the benefits of aspirin are greater than the risks.

* By healthy women over age 65, or women under 65 who have one or more risk factors for heart disease as long as their blood pressure is controlled and the benefits of aspirin are greater than the risks.

Although aspirin offers many benefits, it is not right for everyone. Aspirin`s anti-clotting action can cause unwanted side effects such as stomach bleeding and bleeding in the brain. People with stomach ulcers, a history of gastrointestinal bleeding, blood-clotting disorders, uncontrolled high blood pressure, and liver or kidney disease may need to avoid aspirin.

Aspirin should not be taken by people who are at risk for or who have had a hemorrhagic stroke, which is a type of stroke that is not caused by a blood clot but rather by bleeding into and around the brain. People who are sensitive to aspirin should not take it because it can trigger asthma attacks. It is important to consult with your doctor before taking aspirin if you`re already taking prescribed blood thinners, such as Coumadin, because the combined effect of these two drugs could result in bleeding problems.

Recent studies also show that aspirin therapy does not help patients with peripheral artery disease (PAD). Study co-author William R. Hiatt, MD, of the University of Colorado, Denver, stated that “there is no compelling reason to prescribe aspirin” to patients who do not have documented coronary artery disease. He added that it is far from clear if the benefits of aspirin outweigh the risks in the roughly 4 million to 6 million patients with PAD.

Cardiologist and study co-author Mori J. Krantz, MD, of the Colorado Prevention Center, expressed that a large, randomized study is needed to fully understand the risks versus benefits of aspirin therapy in patients with PAD. “The benefits of aspirin therapy in coronary artery disease are unequivocal, but we can`t say the same for patients with peripheral artery disease,” he said. “In this era of evidence-based medicine, we owe it to ourselves to adequately study this drug regimen in this population.”