It used to be that you would take an aspirin if you had a headache or pain. Then doctors began to appreciate that aspirin could prevent strokes and colon cancer. Many studies now look at the benefits of taking aspirin preventatively. But is it right for you?
Although there are benefits to taking aspirin, there are risks also. Aspirin can irritate the stomach and cause gastrointestinal bleeding and stomach pain. People who take aspirin may bleed or bruise more if they are injured. As in many medical decisions, the risks and benefits must be weighed.
Your doctor should evaluate your risk factors for heart disease and stroke, and weigh them against risks of bleeding that include uncontrolled hypertension, ulcers, or other conditions that make it more likely you might bleed. For those with a history of a heart attack or documented coronary artery disease, and without risks of bleeding, benefits usually outweigh the risks. The use of aspirin for those without documented heart disease is another question. There is evidence to support using aspirin in adults aged 50-59 who have a 10% or greater risk of heart disease in the next 10 years. For those under the age of 50, or older than age 70, individual risk factors need to be assessed.
To prevent colon cancer, it seems that one must take aspirin for 5-10 years before the benefit becomes apparent. There is some evidence that aspirin may decrease breast cancer risk, but not enough evidence to recommend it at this time.
An app has been developed by Dr. JoAnn Manson and her colleagues the Brigham and Women's Hospital in Boston. The app is called Aspirin Guide and it is free.The app is meant to help clinicians determine if low dose aspirin for the primary prevention of atherosclerotic cardiovascular disease. The app uses patient specific information to determine scores for the risk of heart disease and bleeding. It asks for your age, sex, history of gastrointestinal bleeding, blood pressure and cholesterol levels, and certain medications. It is very easy to use, and is a good starting point for a discussion with your physician.
Marilyn C. Jerome, MD
Harvard Women's Health Watch, Volume 25, Number 1, September 2017
Aspirin Guide, an app developed at Bringham and Women's by Samia Mora, MD,
JoAnn Manson, MD, and Jeffrey Ames, BS