The People's Perspective on Medicine

Aspirin Benefits vs Risks

A British meta-analysis of aspirin users suggests that this common preventive medicine may carry significant risks along with modest benefit. Investigators analyzed nine randomized, placebo-controlled studies that included more than 100,000 healthy volunteers. Although those taking aspirin were 20 percent less likely to suffer a heart attack, they were 30 percent more likely to experience a bleeding ulcer. Men who are at high risk for a second heart attack get significant benefit from taking aspirin, but researchers are beginning to question the trade off between heart protection and gastrointestinal hemorrhage for otherwise healthy people. People should only be taking daily aspirin under medical supervision.

[Archives of Internal Medicine, online, Jan. 9, 2012]

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About the Author
Terry Graedon, PhD, is a medical anthropologist and co-host of The People’s Pharmacy radio show, co-author of The People’s Pharmacy syndicated newspaper columns and numerous books, and co-founder of The People’s Pharmacy website. Terry taught in the Duke University School of Nursing and was an adjunct assistant professor in the Department of Anthropology. She is a Fellow of the Society of Applied Anthropology. Terry is one of the country's leading authorities on the science behind folk remedies. .
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I have been taking a baby aspirin for about 10 yrs….I have high blood pressure and high cholesterol, treated with Diltiazim and generic lipitor….I bleed when I have a dental cleaning, when I nick myself, am anemic (I have a colectomy, so blood in the stool is not considered “diagnostic”), and, now, I had an eye exam (after I started getting floaters and flashes, probably from the lipitor, which are now considered to be permanent…it is horrible) and I now have a hemorrhage (I assume it is) in my eye, after 2 wks…my family doctor (who is not very good, but I am on medicaid) says it will go away, but he says that about everything, including a dislocated and badly broken toe, but that is another story…what should I do?
Should I stop the aspirin? I would love to, but have a family history of early death from heart disease and I am 56 yrs old now…..thanks for any replies.

This is so typical of the contradictory reporting about all things having to do with one’s health. Not only is this “report” vague (no mention of doses, etc), but when compared to the latest “meta-analysis” of aspirin use posted on this site (Pain Relievers Lower Skin Cancer Risk) all it does is leave readers even more confused. So, should daily aspirin use be viewed as mainly good, or not so good, where’s the clarity, the bottom line, the connecting of all the disparate dots?
Simply tossing out brief “factoids” is not being of very much service. I’ve been very much into health, particularly holistic alternatives, for over 40 years, and have seen so many studies & reports contradicting each other, that the real bottom line is pretty much what someone like Dr. Andrew Weil does, and that is using our own bodies as the test subjects. We can read all we want, but sure enough, what’s good today, will be found to be harmful tomorrow, and vice versa. That each time a new study is published, it’s made to sound as if it’s conclusive, is a disservice, and really, a farce…
PEOPLE’S PHARMACY RESPONSE: We definitely agree that each new study doesn’t overturn what has gone before, but instead needs to be considered in that context.
The meta-analysis above included nine large studies, not all the same. The dose of aspirin used ranged from 75 mg a day (slightly less than a “low-dose” aspirin in the US) to 500 mg a day (just under two full-dose 325 mg tablets). The point is not that aspirin is bad–or good–but that people need to be aware of what benefits and risks they might derive from taking it so they can make informed decisions. Even Dr. Weil would probably agree with that.

I am allergic to aspirin (causes a rash) so I take nattokinase instead. My doctor knows I am taking this but he had not heard of it before. One online website says: “Nattokinase has been found to have blood clot dissolving abilities and prevents the aggregation of red blood cells.” I learned of Natto from my Dad (age 91) who has been taking it for years instead of aspirin as he believes it is more effective than aspirin.

Did any of these studies specify whether the aspirins taken were coated or not? If so, would coating keep a person from gastrointestinal hemorrhaging?
People’s Pharmacy response: A study several years ago showed that enteric-coated aspirin are safer for the stomach, but can damage the small intestine.

I am an African American female over 50 years old. At my last doctor visit in June of 2011 I received good news for my annual visit. My cholesterol level is in the good range but the doctor suggested that I take a daily aspirin.
Is there something herbal I can take instead of the daily aspirin to get the same blood thinning benefits?
People’s Pharmacy response: Fish oil might be a possibility, but you really should talk with the doctor before making such a substitution. Ask him/her if the aspirin is for primary prevention; if so, it may not make as much sense as once believed.

What daily dose of aspirin did this analysis use?
People’s Pharmacy response: Perhaps because there were several studies included in the analysis, the dose was not specified.

Do you know if this meta-analysis looked at dosage levels? Does low-dosage aspirin carry similar risk factors as the standard dosage aspirin tablet?

I take 1 325mg aspirin a day– I don’t think that will hurt me & both my doctors recommended it.

recent article published on aspirin indicates it may double risk for macular degeneration, ie, leaky blood vessels in the retina (wet form). suggest annual eye exam if taking regular aspirin.
People’s Pharmacy response: Here’s the link to the abstract of that article from Europe last year:

I had an occlusion in the central vein to my retina in my right eye which resulted in permanent damage to the retina. My eye doctor recommended I take one baby aspirin a day, which I have for about a year since I was worried about the other eye.
I now find that I bleed from nicks in shaving and cuts to my hands (I’m a woodworker)and the bleeding persists for a half-hour or so before the blood coagulates. I have stopped taking the asirin and waiting to see if the bleeding problem goes away. This is a worry as I don’t want to jepordise my other eye, but the bleeding is also a worry. I will talk to my GP soon.

I am wondering if there is the same risk associated with White Willow Bark?
People’s Pharmacy response: No big studies like this one have been done, but it is quite likely that the risks are somewhat similar.

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