Aspirin – Friend or Foe?

Posted by on Jul 11, 2014 in News | 0 comments

Aspirin 2Should I take aspirin for heart disease prevention?
You may have heard from the media, friends, family members or coworkers saying aspirin can lower your chance of heart attack. Thus, you may wonder whether you should take a daily aspirin to prevent heart disease. Before you go to the pharmacy and purchase over-the-counter aspirin, there are a few things you need to know.

What is aspirin and how does it work?
Aspirin is one of the medications in NSAIDs (nonsteroidal anti-inflammatory drugs) group. It has been used for pain relief and to reduce swelling. In recent years, low dose aspirin is used to prevent heart disease. Heart disease includes heart attack, stroke and peripheral arterial disease in which poor circulation in the legs. At low dosages, aspirin prevents platelets from clumping. Platelet is one of the blood cells and they play a role in blood clotting. Without platelets, you can bleed to death when you cut yourself or have an injury to your tissues and organs. At the same time, platelets can form clots in the coronary arteries that supply your heart and can cause decrease in the blood flow. When there is insufficient blood supply to the heart, it results in heart attack due to the death of heart muscles. Also, reduced blood flow to the brain can result in stroke. Therefore, the role of low dose aspirin is to prevent platelets from clumping and keep the normal blood flow in the arteries.

Who should take daily aspirin?
You should not take daily aspirin unless prescribed by the doctor. Your doctor may put you on daily aspirin if you belong to this group of people.

The criteria in this group include:
• If you have a history of heart attack
• If you have a history of ischemic stroke or transient ischemic stroke (TIA)
• If you have stable or unstable angina
• If you have had a coronary artery bypass graft (CABG procedure)
• If you have had angioplasty
• If you have atrial fibrillation (A-Fib)
• If you have heart valve disease

Your doctor will decide what dosage is right for you. Some people may get baby aspirin (81 mg) while others may get a regular strength (325 mg). If you take ibuprofen or other NSAIDs for chronic conditions such as arthritis, chronic pain or back pain, talk to your doctor. They can reduce blood clotting like aspirin so you are at increased risk for bleeding.

People who do not belong to the above group:
You are at a higher risk for heart disease if you have diabetes, high cholesterol, obesity and high blood pressure than general population. But it does not mean you should start taking daily aspirin on your own. Many studies have been done on men and women who did not have heart disease and who are over 55 years of age. Aspirin like many other medications comes with side effects. Side effects of aspirin include bleeding more than usual when you have a cut. Some people experience stomach bleeding especially if they have ulcer. Another concern is hemorrhagic stroke which is bleeding in the brain. Aspirin also causes stomach upset such as nausea, vomiting, heartburn and stomach pain. It can also interact with ibuprofen (another NSAID). Therefore, many studies have been conducted to see whether the benefit of aspirin on heart disease is greater than the risk of side effects.

Many studies concluded that whether you should be on daily aspirin must be determined by individual’s risks and benefits from aspirin. Some people may benefit more from aspirin while it may cause more harm to others. Hence, the decision should be made by your primary care doctor who knows about your detailed medical history.

Contributed by Patricia Hsiao M.D.

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