For as long as I can remember my father has sworn by the positive health benefit of taking low-dose aspirin daily. In recent years more medical practitioners and reports have supported this view. Now new research published in PlosOne should leave little doubt in anyone’s minds about the upside for people over 50.
The researchers looked at the long-term economic and population-health impact of broader use of aspirin by older Americans at higher risk of cardiovascular disease. They report that only 40% of people who should be taking it daily are actually doing so.
Robert H. Shmerling, MD, is the Faculty Editor of Harvard Health Publications. Writing in the Harvard Health Journal he explains the implications of the research.
For people in the U.S. ages 51 to 79, a routine dose could, over a 20-year period:
- prevent 11 cases of heart disease for every 1,000 persons
- prevent four cases of cancer for every 1,000 persons
- lengthen national life expectancy by about four months, allowing an extra 900,000 people to be alive in 2036
- save $692 billion in medical costs.
Is there a downside to aspirin?
Dr. Shmerling says it’s important to emphasize this study assessed the impact of low-dose aspirin, such as the 85 mg daily dose often found in baby aspirin; “higher doses may be recommended for other conditions (and come with added risk).
In addition, aspirin can interact with other medications. For example, if you take low-dose aspirin for your heart and ibuprofen for arthritis, it’s important that the ibuprofen be taken at least 30 minutes after or more than eight hours before the aspirin; otherwise, the benefit of the aspirin may be lost.”
Like all medicine, this drug does have its downsides. “Among other side effects, allergic reactions may occur. And, aspirin is a blood thinner and can irritate the stomach. Episodes of bleeding and stomach ulcers can be serious.”
However, he is more positive about the benefits: “This new study suggests that large health benefits are not being realized simply because not enough people are taking aspirin.”
He confirms each person has his or her own set of circumstances that can affect both the risks and the benefits of this treatment, as well as his or her own preferences.
“The decision to take or forego aspirin is a big one — so add this to your list of things to discuss at your next appointment with your doctor.”
Who Should Take It?
Dr. Schmerling says that for those at the highest risk of future cardiovascular problems, including those who have had a prior heart attack or stroke, aspirin is routinely recommended to reduce recurrence.
“For everyone else, recommendations vary. Some experts recommend low-dose aspirin for everyone over age 50. Other guidelines make a more conservative recommendation based on age (e.g., 50–79 years old) and cardiovascular risk factors that predict a heart attack or stroke occurring in the next 10 years.”
Use Aspirin the Right Way
Dr. Mike Roizen and Dr. Mehmet Oz have published extensively on the subject. This is what they have to say:
1. Get your doc’s OK
For some people, the risk for bleeding and/or ulcers with aspirin is higher than average. A review with your doctor is a must before starting aspirin. Factors that boost your odds include age, a history of a peptic or bleeding ulcer, taking pain-relieving NSAIDs regularly for another condition (joint aches), smoking, a heavy alcohol habit, living with chronic emotional stress, and/or having an ulcer right now (treatable with antibiotics in most cases). Your doc may suggest taking an acid-blocking proton pump inhibitor with your aspirin for extra protection.
2. Take your low-dose aspirin this way
We think two 81 mg tablets or 162 mg total a day is the best dose to guard against cardio events and cancer. Take them together or at different times of day – it’s up to you. Always take a half-glass of warm water before and after. This helps dissolve the pills faster, decreasing chances for gastrointestinal irritation and bleeding. Taking your aspirin with a meal also may help. Tip: Skip coated aspirin. There’s no evidence that it protects against bleeding, and it won’t dissolve as quickly in warm water.
3. Stay safe
Limit the amount of alcohol you drink. If you need to take another nonsteroidal anti-inflammatory pain reliever, like ibuprofen, do it 24 hours before or after your aspirin. Don’t take other NSAIDs plus aspirin on a regular basis; the combo cancels out aspirin’s anti-cancer effects, kind of like two drivers competing for the same parking space, then both giving up! Take one or the other. Call your doc if you do notice warning signs such as ongoing stomach discomfort, nausea, pain, or bowel movements that look black or tarry.
4. Keep it up
Be consistent; stopping a daily aspirin suddenly increases the risk for clotting, heart attacks, and strokes (not to mention impotence). And aspirin’s cancer protection grows stronger the longer you take it.
Dr. Mehmet Oz is host of “The Dr. Oz Show,” and Dr. Mike Roizen is chief wellness officer and chairman of the Wellness Institute at Cleveland Clinic.
Robert Shmerling, M.D., is associate physician and clinical chief of rheumatology at Beth Israel Deaconess Medical Center and an associate professor in medicine at Harvard Medical School. He is an active teacher in the Internal Medicine Residency Program, serving as the Robinson Firm Chief. He is also a teacher in the Rheumatology Fellowship Program and has been a practicing rheumatologist for over 25 years.
The full research article was published in Plos One: http://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0166103&type=printable