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Sunday, January 26, 2014

Does Aspirin a day really keep the doc at bay?

The benefits of the common practice of taking an aspirin a day to keep the doctor away, are now under serious dispute. 

Various authors have argued for time immemorial that the benefits of aspirin far outweigh the risks. Not only does aspirin provide protection against cancer, but it also reduces the risk for heart disease and stroke. An aspirin daily can certainly seem like the ultimate supplement and it is very inexpensive.
There were also talks of Aspirin being included in the community water supply so that people would benefit from it. 

This practice is now all set for a change. 
Critics have started panning this molecule. 
Their claim is that there is no evidence that aspirin is effective for the primary prevention of  acute coronary syndromes and stroke. Even if benefit does exist, it may not outweigh the harm. Also, there is no evidence that long-term aspirin should be given to patients even with known cardiovascular disease. 

It is possible that when a stable plaque has ruptured, it becomes unstable, resulting in a coronary 'ulcer'. This is a focus for thrombus generation. Aspirin acts here by inhibiting thrombus propagation. However, once the acute event is over and the 'ulcer' has healed, any reduction in platelet aggregation by aspirin may be offset by inhibition of prostaglandin-mediated vascular wall defences and the increased risk of plaque haemorrhage.

Thus, aspirin, just like an antibiotic, should be given for an acute illness and stopped when the acute syndrome has settled. This could be for a period ranging from 1-6 months. 

Aspirin use is associated with an increased risk of 
  • Dyspepsia, gastro-intestinal bleeding leading to anemia. In patients with cardiovascular disease, iron deficiency anemia is associated with a poor prognosis. 
  • Chronic kidney disease and renal dialysis. 
  • Haemorrhagic stroke. 
  • Possibly deafness and age-related macular degeneration. 
Aspirin may also lessen the benefits of drugs that are known to reduce cardiovascular risk, such as angiotensin-converting enzyme (ACE) inhibitors and possibly beta-blockers. 

On a positive side, aspirin prevents vascular proliferation in tumours preventing their growth, thus retarding the progression of bowel and other cancers. 

There is no denying the blood thinning properties of Aspirin for those with heart problems but there is very little justification to insist that everyone needs to take an aspirin. 

"Advice for the day: If you have a headache, follow the instructions on the bottle. Take 2 and KEEP AWAY FROM CHILDREN. "


  1. Replies
    1. Knowledgeable article !!! Thanx doctor !!!

    2. Knowledgeable article !!! Thanx doctor !!!

    3. Dattatray Belkar26 January 2014 at 20:28

      Good Information.

    4. Thnx sir to share such a helpful knowledge wid us

  2. Yes lots of misconceptions about this they are cleared ...thanks alot for this article

  3. Very important for medical professional persons.
    Thank you Doctor:-)

  4. Baldi,
    Please share the articles you are basing your analysis on. After all, you are a medical doctor who uses evidence based medicine rather than a journalist who writes sensationalist articles. You might have failed to mention that renal disease, hemorrhage, dyspepsia, and most other side effects, are mostly due to much higher doses than the current recommended dose of 81 mg or 75 mg daily for most indications. Do you have data to show for example, that 81 mg of aspirin causes kidney disease? Why not mention NSAIDs as a more common cause of renal disease and hypertension?
    Please comment.