Should You Take Aspirin?

New analysis shows that bleeding risk may trump benefits in those at low risk

For many years, we physicians have recommended aspirin to those individuals who we believe to be at risk for heart disease. Many other people have heard the message that aspirin reduces heart attack and stroke risk, and have made the decision to take aspirin without consulting a doctor. A widely used drug that costs mere pennies a pop, aspirin may seem like a simple and cheap way to ensure heart health. However, a new analysis of over 100,000 people enrolled in nine separate trials and followed for an average of six years makes it clear that for some of us, aspirin may do more harm than good.

The report, published in the January 9, 2012 edition of Archives of Internal Medicine, looked specifically at people who had not suffered a heart attack or stroke and did not have established cardiovascular disease. Overall, there was about a 10 percent reduction in heart attacks and other cardiovascular events, but that benefit came at a 30 percent greater risk of serious bleeding, including ulcers. Anyone who takes aspirin regularly knows that it can make us more prone to bruising. That’s because aspirin reduces the stickiness of our platelets, which are involved in blood clotting. It can also have a direct irritant effect on the stomach lining, increasing vulnerability to ulcers.

Does this mean that you shouldn’t take aspirin? Not necessarily. If you are at high risk for heart disease, then your doctor may decide that the benefits outweigh the risk of bleeding. If you already have cardiovascular disease, then most likely you need aspirin. In those at high risk, aspirin can reduce the likelihood of heart attack and stroke by 15 percent. If you have had a coronary stent or any other vascular stent, then absolutely don’t stop aspirin without your physician’s approval. But if you are simply taking aspirin because it seems like a good idea, check with your doctor to be sure you’re making the best choice.