I recently came across an article in the NY Times Health Blog entitled “Daily Aspirin is not for Everyone, Study Suggests“. Because I believe that aspirin (specifically, a low dose aspirin) is one of the few wonder drugs of our time, I was intrigued. Here is a caption from the article:
In the combined analysis, the researchers found that regular aspirin users were 10 percent less likely than the others to have any type of heart event, and 20 percent less likely to have a nonfatal heart attack. While that sounds like good news, the study showed that the risks of regular aspirin outweighed the benefits.
Aspirin users were about 30 percent more likely to have a serious gastrointestinal bleeding event, a side effect of frequent aspirin use.
This should come as no surprise to anyone, as a side effect of any NSAID (non steroidal anti inflammatory drug) is an increased risk of gastrointestinal bleeding. In 1999, this statement appeared in the New England Journal of Medicine:
It has been estimated conservatively that 16,500 NSAID-related deaths occur among patients with rheumatoid arthritis or osteoarthritis every year in the United States. This figure is similar to the number of deaths from the acquired immunodeficiency syndrome and considerably greater than the number of deaths from multiple myeloma, asthma, cervical cancer, or Hodgkin’s disease.
What is my point? Well, for the recent study, researchers included daily aspirin use of 75-500mg. “Low dose” aspirin, on the other hand, is less than or equal to 81 mg/day (one “baby” aspirin), and recent studies (read HERE, and HERE) have suggested “very low dose” of 20-40mg/day as the most effective in warding off cardiovascular disease.
So, is my view of aspirin changed? Not yet. The more recent “very low dose” studies seem to support a combined approach of omega-3 supplementation (fish oil) with 1/4 to 1/2 of a baby aspirin. At this very low dose, I have yet to read of gastrointestinal bleeding from otherwise “healthy” patients. As always, talk to your health care provider before embarking on or changing an aspirin prophylaxis routine. But also ask enough questions to find out how “up to date” he or she is on the latest aspirin research.