The Dangers of Taking Aspirin Every Day

Once Upon a Time, Doctor's Recommended a Daily Dose Of Aspirin - Not So Often Today....

In This Article –

  • The Traditional Benefits of Aspirin
  • What Has Changed
  • The Danger of Taking Aspirin Every Day
  • Interactions with Aspirin

The Short Answer –

Aspirin has historically been everybody’s friend. But now everything has changed. The short-term cure for mild pain that was often used as a daily treatment that also helped to reduce your blood pressure and thin your blood has lost some of it’s appeal.

New information has shed light on the dangers of taking aspirin every day. The dangers are not inconsiderable and aspirin is now in the dock. In this article we ask – is it still worth the risk?

The Traditional Benefits of Aspirin

Aspirin is well known as the painkiller with the widest potential stream of other health benefits. It is often given as an alternative to other painkillers for patients with a risk of cardiovascular disease or stroke. It’s primary benefits were always seen as two fold – it could help keep your blood pressure low and also potentially prevent future strokes or heart disease.

This is because studies have proven aspirin actually has a blood-thinning impact and thus can be used as a form of anti-coagulant, helping to prevent the body from forming dangerous clots that could ultimately lead to a stroke.

But blood-thinning isn’t the only additional benefit that Aspirin has been linked to. It’s blood thinning properties have also been linked to a reduction in pre-eclampsia (possibly because it aids the flow of blood), but this is highly controversial and still largely unproven. A number of studies, summarized by the US National Library Of Medicine have actually shown it to be completely ineffective in ‘patients at high risk of pre-emclampsia’ in the first place.

Cartoon about someone taking aspirin for every medical condition known to man

Further Benefits of Aspirin

More recently however, successive studies have been able to establish a direct link between aspirin use and the reduced risk of developing various cancers. This started with ovarian cancer, but has now been tried against various colon cancers and also found to help their prevention.

Indeed, in 2015, The US ‘Preventative Services Task Force’ recommended daily use of aspirin to help prevent cardiovascular disease and colorectal cancer.

Since then numerous small studies have been published linking aspirin with a reduced risk of a whole range of cancers.

The theory behind this is not that aspirin attacks cancer cells but that it affects the blood platelets (clotting) that cancer cells would interact with, thus inhibiting their transport and growth. Each study comes out with different results, but broadly the risk of developing many cancers has been linked with long-term aspirin use.

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“….if doing something reduced your chances of being stabbed by 10% in isolation it may sound an obvious choice, but if it also increased your chances of being shot by 90%, the overall sensible decision would be to avoid doing it”.

The Dangers of Taking Aspirin Every Day

However, as with every drug that carries some benefits, there are also downsides that need to taken in to account before making a balanced decision on it’s likely overall impact. It is also a matter of degree of reduced risk vs degree of increased risk.

In other words, if doing something reduced your chances of being stabbed by 10% in isolation it may sound an obvious choice, but if it also increased your chances of being shot by 90%, the overall sensible decision would be to avoid doing it.

Daily doses of aspirin are no different in that while it has some cardiovascular benefits with blood thinning and possibly reduces your chances of contracting some cancers (although by no more than a healthy alcohol-free lifestyle would), thinning the blood also increases your risk of developing a fatal bleed.

Picture of an aspirin tablet

Out With The Old, In With The New…

A new class of specialist drugs have been created that can now offer better control over blood coagulation in the body and have led many clinicians to no longer recommend aspirin for blood clotting control. Instead, this new group of drugs, known as the ‘Direct Oral Anti-Coagulants’ including formulations such as Apixaban and Edoxaban have taken it’s place. These drugs offer far more controlled and effective anti-coagulation with consistent results that are far more appropriate for long-term control in patients at risk of stroke or heart attack.

With these newer anti-coagulants offering better control and less risk of fatal bleeds, long-term Aspirin has gradually been used much less. Warfarin has also been prescribed for much the same reason (blood thinning to prevent heart attacks/ stroke), but again the DOACs increased efficacy has seen them take over in most clinicians’ eyes.

Low dose aspirin

Even with low doses of aspirin however, reducing your bodies’ ability to produce platelets will leave you at greater risk of a haemorrhagic stroke (caused by internal bleeding). Similarly, you are much more likely to suffer gastrointestinal bleeding if you are taking aspirin – and this could very easily become life-threatening if you already have an internal ulcer.

Then there is also the risk that if you start taking a low-dose of aspirin and then decide to stop after your body has become accustomed to it, you can create a rebound effect in which your blood actually clots more and leaves you at much greater risk of a heart attack/ stroke. Before starting any prolonged course of aspirin, it is always best to consult your doctor who can weigh up your relative risk factors and advise you accordingly. Similarly, if you are already taking Aspirin regularly and intend to step down, then you really must see a Doctor first, again so that they can take in to any cardiovascular risks before you attempt to step off the drug.

Possible Interactions

Naturally, if you’re already on a product designed to thin your blood, such as the new direct oral anti-coagulants mentioned above (Apixaban, Edoxaban, Rivaroxyban or Dabigatran) or warfarin, then combining this with Aspirin is likely to greatly increase your chances of a fatal bleed and should only be considered under strict medical guidance. Any other substance that might further thin your blood should also be voided and not be taken in combination. These include –

  • Ibuprofen
  • Heparin
  • Clopidogrel
  • Paroxetine (and other anti-depressants)

There are also a number of dietary supplements that are well known to increase your risk of bleeding –

  • Omega-3 fish oil
  • Evening Primrose Oil
  • Danshen
  • Cat’s Claw
  • Capsaicin
  • Bilberry

The Final Word –

Like all painkillers, it is a matter of risk vs benefits. If you are fit and healthy, there is very little case for taking aspirin in the long term as the reduced cancer risk is proportionately very small as is the chance of a heart attack caused by a blood clot.

However, in specific circumstances (when supported by a face to face diagnosis with a doctor), there are times when long-term use of aspirin could be considered your best option. This will mostly be if you are considered at very high risk of a heart attack or stroke – such as if you’ve already had a heart attack, stroke or suffer with diabetes.

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References –

1. A. Atallah, E. Lecarpentier, F. Goffinet, M. Doret-Dion, P. Gaucherand and V. Tsatsaris. (Oct 2017). Aspirin for Prevention of Preeclampsia. Drugs.
2. April 2016. US Preventative Services Task Force. Final Recommendation Statement. Aspirin Use to Prevent Cardiovascular Disease and Colorectal Cancer: Preventive Medication. 

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