Making a Case for That Daily Dose of Aspirin

Everyone recognizes that preventing disease is important for their future health and well-being. Several recent studies have identified the usefulness of aspirin in preventing some of the most serious illnesses we face.

Many individuals are taking baby aspirin (81 mg) in order to reduce the likelihood of heart attacks. This is important because one out of every two men have a heart attack after age 40, and one out of every three women have a heart attack. Statistically, 38 percent of women and 25 percent of men die within one year of their first heart attack. On average, women are older when they have their first heart attack: 70 years of age for women versus 66 years of age for men.

In a recent article, Dr. T. Wolff and her co-workers from the Agency for Healthcare Research and Quality and New York Presbyterian Hospital (Annals of Internal Medicine, Volume 150, page 405-410, 2009) reviewed all major studies that investigated the use of aspirin to prevent cardiovascular disease or strokes. In their review, these authors found that the risk of heart attack was markedly reduced in men by 32 percent overall, and in women by 12 percent. It is unclear why men were protected to a greater degree than women. (It should be pointed out that in some of these trials, patients received as high a dose as 500 mg of aspirin per day.)

In addition, the use of aspirin to prevent strokes was found to be very important. The lifetime risk for a clotting stroke (ischemic stroke) for women is one in six, and slightly less for men (one out of every seven). The use of aspirin was found to be protective against stroke in females. In women, there was a 24 percent reduction in ischemic stroke. However, in men there was no statistical reduction in the rate of stroke. Again, it is unclear why women benefited more than men.

The authors also pointed out that there was a slight increase in the likelihood of gastrointestinal bleeding events because of aspirin. Thus, it is important for you to discuss with your physician whether you have had evidence of gastrointestinal bleeding in the past, or might be at risk to have gastrointestinal bleeding when receiving aspirin to prevent heart attacks or strokes.

In addition to the protective effects of aspirin in cardiovascular disease and stroke, the risk of cancer is one that is feared by most individuals. One out of every two men and one out of every three women will develop a cancer during the course of their lifetime.

In lung cancer, Dr. K. Moisich and her co-workers at Roswell Park Cancer Institute, The University of Massachusetts, and Moffat Cancer Center (BMC Cancer, Volume 2, page 31, 2002) found that there was a reduced risk of lung cancer by 43 percent in patients who used aspirin regularly. This risk reduction was present in both men and women, and was most effective if patients had the lowest cigarette exposure.

The use of aspirin to reduce breast cancer was found to be effective by Dr. G. Gierach of the National Institutes of Health (Breast Cancer Research, 2009). The reduction in breast cancer was found to be 16 percent. This was effective in preventing estrogen-receptor positive breast cancer, which is responsible for about 75% percent of breast cancers in the United States.

In addition, it has been recognized that aspirin reduces the risk of colon cancer by reducing the occurrence of colon polyps by Dr. L. Rosenburg and co-workers (Cancer Volume 82, page 2326, 1998). 

Again, it is important to discuss with your physician whether you are a candidate for aspirin prevention in order to reduce the likelihood of having a serious tumor or cardiovascular disease. If it is safe for you to take aspirin, discuss with your physician at what age you should start aspirin use, and what dose you should be taking. I have generally recommended a full dose of 325 mg per day for my patients, since it not only protects against cardiovascular disease and stroke, but also cancer. Check this with your doctor before starting.