By Martha A. Simpson, D.O., M.B.A.
Assistant Professor of Family Medicine
Ohio University College of Osteopathic Medicine

DAILY LOW-DOSE ASPIRIN IS OFTEN GOOD FOR HEART HEALTH

Question: Many of my friends take a baby aspirin every day and are surprised that I don't. I am 60 years old and in excellent health. Should I take an aspirin every day? How much should I take? Is it a safe medication?

Answer: Aspirin is an old medicine that was a folk medicine for many years before Bayer started manufacturing it in synthetic form in 1893. The active ingredient in aspirin is salicylic acid that is found in the bark of the willow tree.

Aspirin has many medicinal uses. Here are some of the things aspirin is known to do:
• lower temperature - the antipyretic effect,
• reduce inflammation - the anti-inflammatory effect,
• relieve pain - the analgesic effect, and
• reduce platelet aggregation - the anticoagulant effect.

Aspirin use and dosage varies depending on what you are treating and why.

Low dose aspirin has been shown to prevent heart attacks. This 81 mg dose in now available in an adult form, so adults don't have to take flavored children's chewable tablets. It is also coated so it will be absorbed in the intestines rather than in the stomach. This is important because aspirin and other non-steroidal anti-inflammatory drugs like ibuprofen can cause gastrointestinal bleeding. Over a period of time this can eat away at your stomach lining and cause ulcers. In fact, next to h. pylori bacteria, aspirin -- and it’s more modern cousins --are the second most common cause of stomach ulcers.

Many physicians now recommend that their otherwise healthy adult patients take a low-dose aspirin tablet every day. If you’ve already had a heart attack, your physician may still recommend daily aspirin but at a higher dose of 325mg. That’s about the amount in a regular adult aspirin tablet. This level of treatment with aspirin has been shown to reduce the incidence of repeat heart attack.

And, aspirin has other benefits as well. There is good evidence that taking an adult aspirin tablet soon after the onset of heart attack symptoms may decrease the severity of the attack. A slightly higher daily dose of aspirin –- 160 mg –- has been shown to benefit people with vascular disease. At this level it can help to prevent strokes.

While aspirin is a safe drug with a long and distinguished track record, there can be problems with its use. As I mentioned earlier, it can increases the risk of gastrointestinal bleeding. This is especially true as you get older. It can also interact in a negative fashion with other drugs.

It is important to emphasize that taking aspirin is not a substitute for a healthy life-style. Practicing a healthy life-style – like not smoking, exercising regularly, and keeping your weight under control – are the key factors in preventing heart attacks and strokes.

As you can see, deciding if you need daily aspirin therapy is a complex matter. It depends on your overall health, your health history and what other medications you are now taking. That’s why I can’t make a specific recommendation. Your own family physician is the person to evaluate the risks and benefits of an aspirin regimen in your case.

Family Medicine® is a weekly column. To submit questions, write to Martha A. Simpson, D.O., M.B.A., Ohio University College of Osteopathic Medicine, P.O. Box 110, Athens, Ohio 45701. Medical information in this column is provided as an educational service only. It does not replace the judgment of your personal physician, who should be relied on to diagnosis and recommend treatment for any medical conditions. Past columns are available online at www.familymedicinenews.org.