Do We Underestimate Aspirin?

Some studies seem to suggest that this over-the-counter drug is a "wonder drug"—but it's not without risks.



Fotolia//stevecuk

What if scientists were able to develop a drug that could save hundreds of thousands of lives, cut healthcare costs by nearly $700 billion in the coming years, cost only pennies per pill and were available without a prescription?

Researchers at the University of Southern California say we already have such a drug. It’s called aspirin.

The study goes on to say that only about 40 percent of people who should be taking aspirin are doing so.

Is aspirin really a “wonder drug,” and should we all be taking it?

A flurry of studies indicate that aspirin might be effective in combating a long line of health conditions, including heart disease, stroke and cancer. But in the midst of potential health benefits come a number of risks, a fact some health professionals believe is often overlooked.

“You don’t want to take something that you think is good for you and wind up with something that is possibly catastrophic,” says Jehan Riar, M.D., an internist with Bayhealth Family Medicine in Georgetown.

Aspirin is a synthetic derivative of a compound called salicin, which is found naturally in plants like the willow tree. Early clinical trials found it to be effective treatment for pain, fever and inflammation.

More recently, researchers found aspirin to be an effective blood thinner, preventing the formation of blood clots and thus lowering the risk for heart attack and stroke.

However, taking aspirin on a regular basis is not a harmless intervention. “It’s not a wonder drug for everybody,” Riar says.

Healthcare professionals warn that long-term or high-dosage use of aspirin can cause irritation to the stomach lining, stomach ulcers and, in rare cases, a hemorrhagic stroke.

Some individuals can have an allergic reaction to aspirin, especially people with asthma.

Aspirin can also interact with other drugs, particularly anti-clotting drugs, and consequently increase the risk of bleeding.

In addition, an Australian study linked long-term aspirin use to an increased risk for age-related macular degeneration, a major cause of blindness in older adults.

Other side effects can include headaches, nausea and vomiting, tinnitus and bruising.

As noted earlier, one of aspirin’s many benefits is its ability to prevent cardiovascular disease by preventing the formation of blood clots.

“Aspirin works on both the COX enzymes irreversibly preventing platelet aggregation,” says Laura A. Zizza, PharmD, clinical pharmacy specialist in cardiovascular critical care at Christiana Care Health System.

New guidelines issued by the U.S. Preventive Services Task Force recommend daily low-dose aspirin for heart attack and stroke prevention for individuals aged 50–59 who are at high risk for cardiovascular disease.

Conversely, a 2009 meta-analytical study done at the University of Oxford found that daily aspirin intake produced no benefits for healthy people.

Numerous studies suggest that aspirin can lower the risk of some cancers, including breast, ovarian and colorectal cancers as well as melanoma. In addition, a 2015 European Cancer Congress in Vienna, Austria, suggested that aspirin could double survival rates for patients with gastrointestinal cancers.

Despite these findings, healthcare providers agree that everyone should consult with a physician before engaging in daily aspirin therapy.

“The use of aspirin must be discussed with a healthcare provider, because each patient’s case is different,” Riar says.

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