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Aspirin a day keeps the doctor away? By Sucharu Chris Prakash, MD

Dr. Chris Prakash, eParisExtra columnist
Dr. Chris Prakash, eParisExtra columnist

Q: I have heard that aspirin can prevent heart attack and stroke. Should I take it every day even if I am healthy?

 A: Aspirin (or acetylsalicylic acid) was developed in 1897 by the German chemist Felix Hoffmann, and since that time, has been invaluable as an analgesic. Aspirin has been a mainstay on pharmacy shelves, for relief of pain and fever. We have also known for some time now, that aspirin can help prevent heart attacks and strokes. There is new evidence that indicates that aspirin can also reduce the risk of some cancers, and may even help protect against Alzheimer’s disease.

So, is it safe to say that aspirin is a wonder drug?

Maybe!

Multiple studies and meta-analyses have confirmed that the use of aspirin substantially reduces the risk of cardiovascular disease, and prevents heart attack and stroke in otherwise healthy individuals. This evidence prompted the United States Preventive Services Task Force to strongly recommend that men ages 45 to 79, and women ages 55 to 79, take a low-dose aspirin pill daily, with the exception of those at risk for gastrointestinal bleeding.

Over the past couple of years, there have been several reports about aspirin’s benefits in cancer prevention. In 2011, British researchers, analyzing data from some 25,000 patients in eight long-term studies, found that a small, 75-milligram dose of aspirin taken daily for at least five years reduced the risk of dying from common cancers by 21 percent.

In 2012, The Lancet published a research paper which reviewed five long-term studies involving more than 17,000 patients. It found that a daily low-dose aspirin lowered the risk of getting adenocarcinoma – a common malignant cancer that develops in the lungs, colon and prostate, by an average of 46 percent (for some folks with a particular genetic mutation, it slashes the risk of colon cancer by 82 percent).

How does Aspirin do it?

Aspirin helps prevent cardiovascular disease through a variety of mechanisms, including being a natural anticoagulant (prevent blood clots). It is a powerful anti-inflammatory agent, and many experts believe it helps prevent cancer, in part, by dampening a person’s immune response to damaging insults in the body.

Is Aspirin safe?

Aspirin can cause irritation of the stomach lining and loss of stomach protection. This may make people more likely to bleed. Taking aspirin in coated or buffered form may help lower this risk but does not eliminate it. People, who take aspirin regularly, will have roughly double the likelihood of having a perforated ulcer or bleeding in the GI tract.

So how do you decide whether aspirin is right for you?

As with all medications, individuals should first speak with their health care provider to discuss using aspirin. The doctor will then discuss the potential benefits and harm of aspirin therapy.

The following individuals may clearly benefit from low dose daily aspirin:

  • Those who have a documented personal or family history of heart disease, including heart attacks, stokes, or angina.
  • Those with diabetes.
  • Those who have high blood pressure or high cholesterol.
  • If you are a smoker, or have obesity.
  • All males 45-79 and all females 55-79 years old, if benefits outweigh the risks.

The recommended dose for prevention is 75 or 81 mg daily.

This information is strictly an opinion of Dr Prakash, and is not intended to replace the advice of your doctor. Dr Chris Prakash is a contributing columnist, and author of eParisExtra’s “The Doctor is In” column. He is a medical oncologist at Texas Oncology Paris. He is board certified in Internal Medicine, Oncology and Hematology. He lives in Paris, TX with his wife and two children, and can be reached at 9037850031, or Sucharu.prakash@usoncology.com

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