Health and Psychology

People use aspirin for a lot of things without really understanding what it does.  Aspirin is chemically known as acetylsalicylic acid.  It is used as an analgesic to relieve minor aches and pains, as an anti-inflammatory agent to reduce swelling, as an anti-pyretic agent to reduce fevers, and as a anti-coagulant to thin the blood.

It's this last use as a blood thinner that has come under question.  Many physicians have suggested that patients at risk of a heart attack or a stroke due to vascular occlusions, showing evidence of chronic infammation in lab tests such as elevated C-reactive protein levels or elevated cholesterol levels take a low dose of aspirin (81 mg.).  Others have recommended it only for patients that can't quit smoking or choose to take birth control pills and thus increase their risk of vascular occlusions.

The media has pushed the idea of the general population lowering cholesterol by eating heart healthy foods like whole grains, and taking low dose aspirin.  This idea has prompted many people to take aspirin without a sound evaluation of the risks and benefits of aspirin for them.  For many people the risks of aspirin treatment and resulting bleeding are far more serious than the benefits.  This is especially true in individuals that are taking other medications with anti-coagulation side effects (such as some antidepressants or supplements like fish oil), or people who have a history of bleeding problems like ulcers. 

In healthy people with no history of heart attack or occlusive stroke the benefit of preventing a heart attack will happen for about 7 out of 10,000 people.  For people with a heart attack history the benefit jumps to 250 out of 10,000 people.  In healthy people the risk of a serious bleed from aspirin even at low dose is 5 out of 10,000 people. In many cases the bleed will be life threatening, and not recognized until it becomes serious.  In fact the bleeding can be serious enough to cause a heart attack or hemorrhagic stroke.  

So when should someone take an aspirin?  Talk to your pharmacist about all the medications and supplements you are taking.  Talk to your cardiologist about your risk for heart attack or stroke broke blocked arteries.  Discuss the risks and benefits of all your medications with your prescribing physician and read over the leaflets that come with the packaging.  That should help you make an informed decision about the risks and benefits of aspirin for you.