Low dose aspirin – risks and benefits

Category: Blog

Overestimating heart attack risk means over prescribing medications. This is not our opinion, this is an ongoing controversy in the medical community as we will show you in the research below. We have seen this over prescribing in many of our patients who come into our office with multiple statin and blood thinner prescriptions and low-dose aspirin recommendations. In this article our focus will be low-dose aspirin.

“an increased risk of major bleeding”

A new study (January 22, 2019) published in the Journal of the American Medical Association (JAMA) (1) questioned if low dose aspirin’s benefits in preventing heart attacks and strokes in low-risk patients outweighed the risks of exposing these patients to bleeding episodes from the aspirin’s effect on the gastrointestinal tract.

Here is, according to researchers, an example of over prescribing. The patients in this study were considered low risk for heart attack and stroke patients, yet they were given low dose aspirin recommendations because that is the “standard of care.” What this research found was that there was a higher risk for MAJOR bleeding episodes in these patients and the health problems they present than the risk benefit of preventing heart attacks and strokes.

The risks associated with low dose aspirin have been discussed before

This is not new news. The problems of bleeding associated with low aspirin use has been explored in the research with equally troubling results.

In October 2018, over 2000 researchers and health care professionals collaborated on a study that appeared in the New England Journal of Medicine (2) that presented this conclusion to their findings:

  • “The use of low-dose aspirin as a primary prevention strategy in older adults resulted in a significantly higher risk of major hemorrhage and did not result in a significantly lower risk of cardiovascular disease than placebo.”

Researchers in Spain recently noted in the journal Alimentary pharmacology & therapeutics (3) that in patients with low cardiovascular risk the number of gastro-intestinal complaints induced by low-dose aspirin may be greater than the number of cardiovascular risk events prevented. Further, in patients with high cardiovascular risk, low-dose aspirin is recommended, but the number of gastro-intestinal complications induced may still overcome the cardiovascular events saved.”

Another and earlier 2012 report in the Journal of the American Medical Association (JAMA) (4) found aspirin use was significantly associated with an increased risk of major gastrointestinal or cerebral bleeding episodes.

Researchers writing in the Archives of Internal Medicine (5)  have questioned the routine prescribing of low-dose aspirin as a preventive measure for cardiovascular disease in patients without prior cardiovascular disease problems.

This is what they said: “The net benefit of aspirin in prevention of cardiovascular disease and nonvascular events remains unclear. Despite important reductions in nonfatal MI (Heart Attacks), aspirin prophylaxis in people without prior cardiovascular disease does not lead to reductions in either cardiovascular death or cancer mortality. Because the benefits are further offset by clinically important bleeding events, routine use of aspirin for primary prevention is not warranted and treatment decisions need to be considered on a case-by-case basis.”

Is low dose aspirin the right option for you?

It is very important to talk to your doctor about whether or not aspirin is appropriate for you. Especially if you have heart disease, prior heart surgery or chronic chest pain due to clogged arteries.

At the Magaziner Center for Wellness we use a functional medicine approach to treat heart disease naturally. Whereas conventional healthcare focuses on the use of medication or other methods that suppress symptoms or block the natural function the body, we use natural therapies that work in conjunction with the body. Our treatments work by facilitating, enabling and assisting normal physiologic reactions. In other words, rather than fighting the body and its natural function, we support it, giving it the tools it needs to heal itself.

Using a series of extremely thorough tests, we work to determine the root cause of the imbalance and develop an individualized plan of treatment based on each patient’s unique needs and contributing factors. No two patients are identical so we look at each patient’s lifestyle, stressors, environment, heavy metals, diet, health history, and the level of vitamins and minerals or any toxins present in the body to determine the specific and unique factors contributing to the imbalance. Using methods such as chelation therapy, various nutrients and nutraceuticals to improve heart function, and anti-inflammatory based-diet and lifestyle, stress reduction techniques and controlled exercise, we treat the cause of the imbalance, rather than the symptoms, helping the body to return to a state of optimal health—fully and naturally.

 

1 Zheng SL, Roddick AJ. Association of aspirin use for primary prevention with cardiovascular events and bleeding events: a systematic review and meta-analysis. Jama. 2019 Jan 22;321(3):277-87.
2 McNeil JJ, Wolfe R, Woods RL, Tonkin AM, Donnan GA, Nelson MR, Reid CM, Lockery JE, Kirpach B, Storey E, Shah RC. Effect of aspirin on cardiovascular events and bleeding in the healthy elderly. New England Journal of Medicine. 2018 Oct 18;379(16):1509-18.
3. Lanas A, Polo-Tomás M, Casado-Arroyo R. The aspirin cardiovascular/gastrointestinal risk calculator – a tool to aid clinicians in practice. Aliment Pharmacol Ther. 2013 Feb 17. doi: 10.1111/apt.12240.
4. De Berardis G, Lucisano G, D’Ettorre A, et al. Association of aspirin use with major bleeding in patients with and without diabetes. JAMA. 2012;307(21):2286-2294. doi:10.1001/jama.2012.5034.
5. Seshasai SRK, Wijesuriya S, Sivakumaran R, et al. Effect of aspirin on vascular and nonvascular outcomes: meta-analysis of randomized controlled trials. Arch Intern Med 2012; DOI:10.1001/archinternmed.2011.628.