Far from obsolete
It’s familiar, available over the counter, inexpensive and versatile. For as long as aspirin has been around, it still has a place in most medicine cabinets. Aspirin belongs to the class of medications called nonsteroidal anti-inflammatory drugs. As a painkiller and fever reducer, aspirin competes with many medications, such as acetaminophen (or Tylenol) and newer NSAIDS, including ibuprofen. If anything, anticlotting and preventive properties may be aspirin’s real benefits. An influential government health panel recommends that adults ages 50 to 69 take low-dose aspirin to prevent heart disease, stroke and colorectal cancer. However, aspirin isn’t for everyone. Here’s what you should know about aspirin’s pros and cons.
Its long-term use has been linked to hearing loss in men.
In the March 2010 issue of The American Journal of Medicine, researchers reported that regular aspirin use — at least twice weekly — upped the risk of suffering hearing loss by 12 percent in men. Those younger than 50 had a 33 percent increased risk of hearing loss. Use of other NSAIDs or acetaminophen also increased the risk of hearing loss. As for women? A December 2016 study in the American Journal of Epidemiology, using data from more than 54,000 women in the Nurses’ Health Study, did not find a significant association between hearing loss and long-term use of regular-dose aspirin in women. Reasons for this discrepancy are unknown.
It may lower preeclampsia risk during pregnancy.
A research review published in The Lancet in 2007 suggested that pregnant women who took aspirin or other antiplatelet drugs were 10 percent less likely to develop preeclampsia, which involves high blood pressure and potentially serious complications for mother and fetus. In September 2014, the U.S. Preventive Services Task Force recommended the use of low-dose aspirin after 12 weeks of gestation for women at high risk for preeclampsia.
It may boost colon cancer survival.
A 2009 study in the Journal of the American Medical Association suggested that aspirin use in certain patients who had colorectal cancer may improve survival. And the journal Gastroenterology published a study in 2008 that found a significantly lowered risk of developing the cancer in men using aspirin (and NSAIDs) regularly over the long term, although in larger-than-usual doses. In 2016, a large study from Norway, published in the July issue of the Journal of Clinical Oncology, confirmed aspirin’s benefit for people with colon cancer. Of nearly 23,000 participants, those using aspirin for more than six months had better colon cancer survival rates and better survival overall. Across many studies, colon cancer has shown the most definitive results among all types of cancer for aspirin’s preventive benefit.
It possibly helps reduce breast cancer risk.
A February 2010 report based on data from the Nurses’ Health Study suggested women with breast cancer who took a low-dose aspirin two to five times weekly were 71 percent less likely to have a deadly recurrence than those who took little or no aspirin. And a large study in the May 2017 issue of Breast Cancer Research looked at data from the California Teachers Study and found women who took three or more tablets of low-dose aspirin weekly were less likely to develop breast cancer. However, according to the National Cancer Institute, the jury is still out on aspirin’s preventive benefit for cancer (other than colorectal cancer).
It reduces the risk of heart attack.
Aspirin prevents clots from forming in the blood vessels and blocking blood supply to the heart. With aspirin and heart attack prevention, the issue is exactly who should take it and at which dose. The American Heart Association recommends that people with a high risk of heart attack take a daily low-dose aspirin after a discussion with their health care provider. Heart attack survivors should regularly take low-dose aspirin, according to the AHA. However, the association warns, people who have bleeding problems, are allergic to aspirin or drink alcohol regularly should not take preventive aspirin.
It helps prevent strokes, with exceptions.
Daily aspirin may prevent stroke, especially among women. However, a small study published in 2008 in the Journal of Clinical Pharmacology found that stroke patients who took daily aspirin to prevent a subsequent stroke and also took ibuprofen — say, for their arthritis — reaped no anticlotting benefit. After a patient stopped the ibuprofen, the aspirin became effective. The Food and Drug Administration warns that aspirin’s benefits may be diminished by ibuprofen, and in 2014, the FDA strengthened its warning around increased stroke (and heart attack) risk from ibuprofen and other non-aspirin NSAIDs. Note that aspirin is not recommended for use during a stroke.
It can cause reactions in some people with asthma.
For about 10 percent of people with asthma, and even more if you include those with asthma and nasal polyps, taking aspirin or NSAIDs can cause reactions or asthma exacerbations. A chronic condition, known as aspirin-exacerbated respiratory disease, or AERD, leads to loss of the sense of smell and an inability to enjoy eating, according to the American Academy of Allergy, Asthma and Immunology. Once the condition is diagnosed with a test called an aspirin challenge, AERD can be treated.
It may worsen stomach woes.
People taking aspirin or another NSAID are at higher risk of gastric bleeding and stomach ulcers — particularly with long-term use of the drug. What people may not realize is that other drugs contain aspirin as well. In a web post on aspirin-containing antacids, the Food and Drug Administration warns consumers: “There is risk of serious bleeding when using over-the-counter antacid products that contain aspirin to treat heartburn, sour stomach, acid indigestion or upset stomach.” Most at risk are people 60 and older, those with a history of stomach ulcers or bleeding problems, or those who take a blood-thinner (such as warfarin), steroids or other NSAID-containing medicines.
It may increase the risk of bleeding.
Aspirin is a blood thinner: It makes the blood’s platelets less sticky, so to speak. Because of this mechanism, the drug makes blood less likely to clot. This is especially risky if bleeding occurs in the brain, which can be fatal. A large Danish study, published online Feb. 28, 2017, in the Journal of the American Medical Association, looked at data for 10,000 adults who had been diagnosed with brain bleeds. Use of antiplatelet drugs — including aspirin — contributed to higher risk in this group.
It can provide emergency first aid.
Always keep regular, full-strength aspirin (325-milligram tablets) handy, advises the January 2014 Harvard Health Letter. Many doctors advise people who think they’re having a heart attack to chew an aspirin right after calling 911. Emergency aspirin may reduce the extent of heart damage from a heart attack. Chewing the tablet releases the anticlotting ingredients into your bloodstream more quickly than swallowing.
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10 Health Pros and Cons of Aspirin originally appeared on usnews.com
Update: This slideshow was originally published on March 2, 2010.
