The benefits and risks of aspirin

Question from a reader: I’m 38 years old and healthy. I exercise three times a week. I read about the benefits of aspirin on the Internet. I’m thinking if I should take it?

Answer: Yes, aspirin is, indeed, a useful drug — it has been shown to prevent a heart attack and stroke. It’s very effective. However, not every person will benefit as much from it. There’s more to taking aspirin than meets the eye.

An American doctor recently warned against the over-the-counter use of aspirin, saying there is great potential for abuse. And it is here that we must carefully weigh the benefits and risks of taking aspirin. 

WHO WILL BENEFIT FROM ASPIRIN?

If you fall in the category of a middle-aged male with heart disease (blockage of the arteries), then you need to take aspirin. Those with stroke, diabetes, and high cholesterol may also benefit from aspirin. But for the healthy and the young, the risks may outweigh the benefits.

DANGERS OF ASPIRIN INTAKE

First, aspirin or acetylsalicylic acid, is really an acid, so it can erode the lining of the stomach and cause serious bleeding. Dr. Virgilio Bañez, a fellow of the Philippine Society of Gastroenterology, believes that Filipinos are more prone to bleeding ulcers from aspirin intake as compared to Caucasians. There has even been a report of a single aspirin tablet perforating the stomach.

Another potentially fatal side effect is brain hemorrhage or bleeding in the brain. Aspirin is a blood thinner and interferes with the normal clotting mechanisms of the body. It can cause bleeding and bruises. That is why doctors advise their patients to stop taking aspirin for seven days before a surgical or dental operation. And on rare occasions, there are those who are allergic to aspirin.

 BENEFITS OF ASPIRIN

Hopefully, I haven’t scared you that much with the risks mentioned. Now, let’s look at the health benefits. Aspirin has been proven time and time again to prevent heart attacks and strokes. Recently, studies suggest that aspirin may also prevent some cancers of the intestine. And its greatest advantage, of course, is its affordable cost.

FINAL JUDGMENT

In a reputable combined analysis (called meta-analysis) of all the positive and negative aspirin data published in the last century, doctors came up with the following conclusions:

1. Aspirin is beneficial for patients who have suffered a heart attack or a stroke.

2. Aspirin is beneficial for patients with diabetes, heart disease, high cholesterol levels, and those with controlled high blood pressure.

3. Aspirin is harmful for patients with peptic ulcer, gastritis, and aspirin allergy.

Now, if you fall somewhere in-between the above categories, the merits of aspirin intake are less certain. You should consult your doctor first before making a decision to take aspirin or not.

WHAT DOSE OF ASPIRIN TO TAKE? 

Many years ago, aspirin was given at a dose as high as 1,600 mg per day while more recent studies suggest that a dose as low as 30 mg may already provide some heart protection. For Filipinos, 80-100 mg of aspirin is the usual dose. Your doctor may prescribe higher or lower doses depending on your risk factors.

ALTERNATIVES TO ASPIRIN

Ginkgo biloba has a blood-thinning effect similar to aspirin. The ornamental tree Ginkgo biloba came from China thousands of years ago. It has been reported in scientific journals to enhance blood circulation and to increase oxygen supply to the brain and heart. A study in the Journal of the American Medical Association also showed that Ginkgo has some beneficial effect on dementia in people with Alzheimer’s disease. However, Ginkgo and aspirin do not add up well because the combination of these drugs may cause internal bleeding.

Another alternative to aspirin is the drug clopidogrel. The reputation of this drug is quite good and it is less irritating to the stomach. However, it is several times more expensive than aspirin.

Lastly, in answer to our reader’s question, I see no need for him to take aspirin for the moment. He should just continue with his healthy lifestyle. Consult his personal doctor for a routine checkup to be sure.