Rarely does a week go by that I don’t give at least one patient 300 mg of aspirin.
For people with acute chest pain and possibly a heart attack, it can literally be a life saver.
It helps make the blood less sticky and breaks up clots in the arteries, allowing oxygen to get to the heart muscles.
Aspirin comes in low and high doses and is available at most pharmacies.
There is a large dose of 300 mg to treat a suspected heart attack or as an anti-inflammatory and pain reliever; and a daily dose of 75–100 mg is taken to prevent heart attacks and strokes.
But as with any drug, there are risks.
For people with acute chest pain and possibly a heart attack, aspirin can be life-saving. It helps make the blood less sticky and breaks up blood clots in the arteries, allowing oxygen to get to the heart muscles (File Photo)
The unique problem with aspirin is that it’s cheap and widely available, making it easy to self-prescribe.
In fact, it’s believed that millions of seemingly healthy people in this country take it every day to prevent a heart attack or stroke.
Salicylic acid, extracted from the bark of willow trees, has been used as an anti-inflammatory drug for centuries.
Then, in 1899, the pharmaceutical company Bayer purified it and created the drug we know as aspirin.
Originally used to treat arthritis, a general practitioner in California discovered its role in preventing heart attacks and strokes in the 1950s, and it was quickly hailed as a miracle cure.
Doctors began recommending that anyone over the age of 55 who feared they were at risk of having a heart attack could take the drug daily for prevention.
Go with the dash
Three servings of whole grains a day may help protect against heart disease, new research shows.
Here’s Ruth Kander, a nutritionist at Fleet Street Clinic in London, sharing tasty ways to hit your “three a day.”
Quinola Puy Lentils and Whole Grain Express Quinoa, 250g, £2.35, ocado.com
Quinoa and Puy lentils are a source of fiber and protein and help keep you feeling full. Quinoa is one of the few plant-based proteins that contains all nine amino acids necessary for muscle building. Two tablespoons count as a whole grain serving.
dr Karg’s 3 Grain 3 Seed Crispbread 200g, £2.50, sainsburys.co.uk
Made with whole-grain spelled, wheat and oat flours, sesame, pumpkin, sunflower and flaxseed, this 5g provides fiber — just over 16 percent of the recommended daily allowance — in two crispbreads that count as one whole-grain serving.
Biona Short Grain Brown Rice, 500g, £2.99, biona.co.uk
Short-grain brown rice combines and becomes creamy as it cooks, making it ideal for risottos. It contains almost twice the fiber of white rice and is a good source of magnesium, which is important for blood pressure. Two tablespoons count as a whole grain serving.
Aspirin acts on platelets, which play a key role in blood clot formation. But here’s the problem: the way it works is also the way it can do harm.
Over the years, there have been a number of studies that reinforce warnings about the drug’s side effects, which include internal bleeding and stomach ulcers.
Just a week ago, some news agencies reported on a study that raised the risk of anemia [where your body doesn’t have enough red blood cells, usually a result of bleeding] in elderly patients.
The study, published in the journal Annals of Internal Medicine, looked at data from more than 19,000 people over the age of 65 in the US and Australia who took daily low-dose aspirin (100 mg) or a dummy pill for a five-year period.
The theory was that aspirin would increase life expectancy and reduce the risk of dementia.
The results showed that taking aspirin made no difference – but that it did come with risks.
As we age, the risk of anemia increases for many reasons: less iron is absorbed by our intestines, the bone marrow is less effective at making red blood cells, and the kidneys produce less of the hormone erythropoietin, which helps with red blood cell production.
However, the study showed that the risk of anemia was 20 percent higher in older people who took aspirin than in those who took the dummy pill.
When the researchers investigated the causes, they found that people who took aspirin had lower iron levels — which was almost certainly due to more stomach bleeding.
It wasn’t just minor bleeding, either; The rate of devastating stomach bleeding was 50 percent higher in those who took the aspirin than in those who took the pacifier.
So what does this mean for you and me?
A few years ago I was treating a man in his seventies. He lived a very healthy life: he was a non-smoker, ate well and played tennis three times a week.
He had seen two of his friends die of heart attacks and had read about the benefits of taking a low dose (75mg) of aspirin daily – the dose you can buy at any pharmacy.
He came to the emergency room because he was dizzy. His blood pressure was low and just as we were trying to figure out what was going on, he gave us the answer by vomiting bright red blood.
We gave him six bags of blood and immediately took him to an endoscopy to see what was going on.
The bleeding came from a stomach ulcer and was stopped.
The cause was almost certainly the aspirin he was taking – but shouldn’t have been taking. He survived but was lucky.
This new study confirms that aspirin can be dangerous if taken for a long time, especially if you’re older.
It may also not be appropriate for doctors to recommend it as a preventive treatment, as they often do if you haven’t had a heart attack or stroke.
In 2022, the U.S. Preventive Services Task Force changed its recommendation for those over 60 to not take daily aspirin to prevent a first heart attack or stroke because the benefit outweighs the potential risk of internal bleeding.
(The advice is different if you’ve had a heart attack or stroke and are trying to prevent another one.)
The NHS also says you should only take low-dose aspirin daily if your doctor recommends it because of a high risk of heart attack or stroke.
We are also cautious about prescribing long-term aspirin. The 2022 NHS guideline says it should be used with caution in the elderly and people with anemia.
What about those who take aspirin because they have a specific heart rhythm problem?
My advice is to seek advice from your doctor; There are new drugs that are more effective than aspirin.
How about taking it before a flight to reduce the risk of deep vein thrombosis?
The answer is a clear no. The risk of triggering a bleed at 35,000 feet is too high.
Instead, walk regularly and wear compression stockings.
Aspirin is still a medicine to have at home for emergencies, because if you have severe chest pain, a dose of 300 mg could make a big difference in your chances of survival.
However, as a general rule, you should not self-medicate – always discuss this with your doctor first.
Twitter: @drrobgalloway
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