An Aspirin a Day Won’t Keep the Doctor Away

Men and women who have been taking aspirin daily in the name of staving off heart attack and stroke may need to reconsider, according to a recent Wall Street Journal article.

In the past, physicians recommended a daily dose of aspirin for older adults as a preventative measure against stroke and heart attack. Now, however, medical experts are advising many of those adults to consider shelving the over-the-counter drug. The concern: For some people, aspirin’s side effects, which range from bleeding ulcers to even bleeding of the brain, may be more dangerous than the benefits the pill provides.

In the article, medical experts advice against a one-size-fits-all approach to recommending aspirin:

 “We would like doctors to re-look at their patients who are on aspirin and consider recommending stopping it where the chance of harm outweighs the benefit,” says Ned Calonge, a Colorado public-health official who serves as the task force’s chairman.

And the new stance on the situation is not just confined to the U.S. alone; Colin Baigent, a professor at Oxford University who coordinated a parallel analysis states: “You really have to have a clear margin of benefit over hazard before you should be treating healthy people.”

For those for whom aspirin’s benefits outweigh the risk, the U.S. Preventive Services Task Force suggests a low daily dose, such as that contained in “baby” aspirin.

So, if you are in a risk category for heart disease and stroke, should you or shouldn’t you be taking a daily dose of aspirin. The answer is, it depends. Here are the new guidelines from the U.S. Preventive Services Task Force, as listed in the Wall Street Journal:

Aspirin recommended for:

• Some men 45 and older with risk factors for heart disease, assuming no history of ulcers or other bleeding dangers.

• Some women 55 and older with risk factors for stroke, and no history of bleeding danger.

Aspirin not recommended for:

• Men younger than 45, and women younger than 55.

• Anyone 80 and older.

Determining risk vs. benefit is not always clear cut, however. Since the same factors that increase patients’ risk of bleeding also increase their risk of developing heart disease, the pros and cons of taking the over-the-counter blood thinner often increase side by side.