Is there a prophylactic use for aspirin?


 


            All people over the age of 20 years would benefit from taking a low dose of aspirin per day. Various researchers can attest to this.


            A study found that taking aspirin every day for five years lowers the chances of developing cancers of the mouth, throat and oesophagus by two thirds. Another study shows that a daily dose cuts by a third the risk of colon polyps – small growths considered to be precursors to colorectal cancer (2003). These findings come on top of well-established evidence over the past 20 years showing that aspirin can significantly reduce the probability of a heart attack or stroke. A number of studies have conclusively shown that aspirin can significantly reduce the risk of heart attacks, strokes and other serious disorders of the vascular (blood) system.


            Despite the overwhelming evidence of aspirin’s benefits, it can have side effects. One study found that men with high blood pressure are unlikely to benefit from aspirin’s anti-stroke effects, and might even put themselves at higher risk if they take the drug each day. A number of studies have also shown that the drug can produce gastro- intestinal bleeding. Oxford researchers who analysed 24 studies found that bleeding occurred in 2.5 per cent of patients taking aspirin, compared with 1.4 per cent in those who did not (2003).


            Aspirin’s role in preventing initial cardiovascular events in women was dramatically focused by the results of the first study to test aspirin prophylaxis in a large number of apparently healthy women, the Women’s Health Study (2005).


            The clearest result was that among women at least 65 years old, a regimen of 100 mg of aspirin every other day cut the incidence of ischemic stroke, MI, and all major cardiovascular disease (CVD) events, while causing a small number of adverse events. Among women younger than 65, the benefit was limited to cutting the risk of ischemic strokes, and the reduction was so modest that aspirin prophylaxis will have to be targeted to a select group of women for whom the likely benefits of regular aspirin will outweigh the risks (2005). Prophylactic aspirin is an option for women aged 65 or older if their blood pressure is controlled.


            Aspirin, even in low doses, is associated with adverse events, primarily of gastrointestinal tract bleeding. These risks appear to be unrelated to the risks of CVD. So there is considerable variation in the overall risk-benefit ratio for an individual as those with low CVD risk will be at the same risk level of gastrointestinal bleeding as those at high CVD risk (2005).


 


 



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