Lower Blood Pressure

Doubts have been raised over the value of taking Aspirin and low dose Aspirin for your heart, as scientists now believe a daily dose could do more harm than good. New research reveals that taking a daily aspirin to ward off heart attacks could do more harm than good!

What is a low dose Aspirin?

For many years we have been led to believe that taking a low dose of aspirin – typically 75mg per day, is beneficial for our heart health and in minimising the risk of developing a heart attack.

A recent study conducted by Scottish Scientists however, has cast doubt over the benefit of aspirin as a simple, cheap heart medication.  A more in-depth analysis of this research though, reveals that this applies only to preventing a first heart attack, and that Aspirin is still effective at preventing a second or repeat heart attack. The study also highlighted though that taking aspirin does increase the risk of internal bleeding.

Aspirin and the Healthy Middle Aged

Many healthy middle-aged people, also known as the ‘worried well’, decide to take low dose aspirin as a precautionary measure, even though they currently have no symptoms of cardiovascular disease.

Aspirin effectiveness trial targets diabetes sufferers

The scientists’ claim follows a study of type 2 diabetes sufferers which discovered that regular daily doses of the medication apparently fails to prevent victims of type 2 diabetes suffering a first cardiac arrest. This group was chosen as Aspirin is widely prescribed to diabetics, who are at much greater risk of heart disease than the general population. However, the scientists also advised that those people already taking small daily doses of aspirin against giving it up without consulting their doctor. Professor Jill Belch, of the Institute of Cardiovascular Research at Dundee University, Scotland, said: ‘If you’re taking aspirin for secondary prevention because you’ve had a heart attack or stroke, or have a circulatory problem, then it works’. ‘But it doesn’t work if you have none of these problems, and there is also no evidence for its use by healthy middle-aged people.’ She added, however: ‘We do not want people taking aspirin prescribed by their doctor to stop taking it without seeking medical advice. They may have conditions for which it is suitable.’ Around 2.3million Britons have type 2 diabetes, which is closely linked with growing levels of obesity, and they are up to five times more at risk of heart disease than the general population.

Aspirin’s established reputation in heart attack prevention

Aspirin does have an established reputation for reducing the risk of repeat heart attacks and stroke by up to a third. However, a major study suggests that diabetics who have not had a previous heart attack gain no benefit from a daily dose.  Professor Belch’s paper published recently in the British Medical Journal, involved 1,276 patients aged over 40 with diabetes and evidence of artery disease, who had not suffered a previous heart attack. It found after eight years that there was no overall benefit from either aspirin or antioxidant treatment in preventing heart attacks or death. Patients in the aspirin groups had 116 heart attacks compared with 117 in those given placebos. Professor Belch said there was widespread prescribing of aspirin in diabetes despite the lack of evidence to support it’s use. But studies show it can double the risk of stomach bleeding from an ulcer.

Side effects of Aspirin and low dose Aspirin treatments

‘Unfortunately aspirin has side effects and it’s one of the biggest reasons for admission to hospital for drug-related adverse reactions, mainly gastrointestinal bleeding. ‘Although the risk is relatively small, the numbers taking aspirin is large so it’s a major problem.’ Professor Belch said there was international opposition to the study, mainly because U.S. guidelines recommend routine use of aspirin in patients with type 2 diabetes and millions are taking it. ‘They were adamant that it was unethical to carry out this trial but I’m glad we persevered.’ She said clinical guidelines from various UK organisations recommending aspirin as primary prevention for diabetics should be changed. There has also been growing pressure for ‘blanket prescribing’ of aspirin in middle age, with a report only last month from Nottingham and Sheffield researchers suggesting most healthy men over the age of 48 and women over 57 would benefit from the drug. Research such as this has encouraged healthy middle-aged people to start taking aspirin bought over the counter without seeing a doctor – despite it not being recommended by any medical body. Aspirin is also an ingredient of the ‘ Polypill’, a single cheap multi-drug tablet being developed to slash the toll of heart attacks. But this one-size-fits-all approach might now have to be rethought, said Professor Rory Collins, of Oxford University, a pioneer of large-scale studies into the causes and treatment of heart attacks. His team is observing 10,000 diabetics who have been allocated daily aspirin or placebo, and has carried out a major analysis of existing studies. The findings show any small benefit from using aspirin in those who have not had heart attacks is outweighed by the risk of stomach bleeding, he said. ‘There has been a conflict between guidelines recommending the use of aspirin as primary prevention and the lack of evidence supporting this. ‘But a lot of GPs are following these guidelines. When we were recruiting for our study, we found practices where all diabetic patients were being prescribed aspirin. ‘The evidence is not there but the risk of bleeding is – and it goes up with age.’