12 Apr

Will an Aspirin a Day Keep the Doctor Away?

For many years it was common to advise seniors to take a daily dose of aspirin to prevent a heart attack, stroke, and other cardiovascular complications.

It seemed to be working. Not any more. As more data has accumulated, the old adage, Take two and call me in the morning,” has come into question.

Based on the latest research, the American College of Cardiology and the American Heart Association is advising against daily aspirin use for prevention because, “It may actually cause more harm than good.”

For decades, we prescribed aspirin to preclude clot formation, a forerunner to a heart attack or stroke, and based on the then “current studies,” we thought a low dose of aspirin was a perfect preventative measure. But as time passed and more data was accumulated, it became noteworthy that more people were having bleeding complications. It seems we were creating more health havoc through a simple prevention tactic. While the benefits of this wonder drug were pushed, many suffered the consequences of having thin blood, internal bleeding, strokes and other manifestations of blood loss.

The daily dose of aspirin is no longer recommended for older adults who don’t have a high risk or existing heart disease. Instead, the focus is on promoting a healthy life style and reducing those lifestyle factors which can be modified such as smoking, diet and exercise.

It has also proven beneficial for any individual of any age who has already had a heart attack, stroke, or vascular intervention like stents or angioplasty. The benefits far outweigh the risks.

Though currently out of vogue, the history of aspirin is still fascinating. Aspirin comes from the bark of the willow tree and has been known for centuries for its healing properties. Records dating as far back as 3000 BC corroborate the medicinal properties of the willow as a pain reliever used by ancient civilizations like the Sumerians and Egyptians. The Greeks administered it in tea form to help relieve the pain of childbirth in the year 300.

Fast forward to 1828 when a pharmacy professor in Germany extracted the active ingredient, salicin, from the willow tree. In a clinical trial in the late 1800s, salicin was found to reduce fever and joint inflammation in patients with rheumatism. About the same time German Pharmaceutical Company Bayer figured out how to purify the salicylic acid with acetic acid, aka vinegar. They patented ‘acetylsalicylic acid’ as ‘aspirin’, a brand name which became generic like Kleenex, Xerox and Scotch tape.

This brings us back to modern times where aspirin is still one of the most researched drugs in the world, with more than 700 clinical trials conducted each year. 

Back to the new guidelines for aspirin. Here’s a word of advice: People who were taking the aspirin proactively should not stop it cold turkey but speak to their medical professional.

Case in Point: I have a patient in his 50s who read the news and stopped taking the aspirin despite his history of stents and angioplasty. Several weeks later he was rushed to the emergency room with a heart attack as a clot had formed in one of his coronary arteries. He lived to tell his story and be a warning to all considering taking their health into their own hands.

But for anyone who has had a heart attack, stroke or any cardiovascular-related disease, the standard dose of aspirin taken proactively can be a lifesaver.

And you don’t need to wait until the morning to call me.