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Is Aspirin Really a Wonder Drug?

It is proven to reduce pain and has been shown to help prevent or reduce the risk for a variety of health conditions, including heart attack, stroke and cancer. But is aspirin really a "wonder drug?”

Researchers in the UK are currently undergoing the largest clinical trial of aspirin in history. 

It’s called the Add-Aspirin phase 3 trial.1

The study is designed to determine whether aspirin is effective for preventing the recurrence of cancer by studying 11,000 people. 

The study is creating quite a buzz in the scientific community, with many health experts suggesting that this in fact could be a turning point in the fight against cancer, if the drug is found to be effective. 

Aspirin if it works, may offer an inexpensive strategy for improving the survival rate of cancer patients.  

And cancer may just be the beginning, however, along with the potential health benefits of aspirin there’s also a long list of potential health risks, and that has some doctors concerned.

"Because it's been around a long-time people think 'it must be safe and it can't do me any harm,'" Prof. Peter Weissberg, medical director of the British Heart Foundation in the UK, told a prominent News Source "They are taking it 'just in case,' but it's much more dangerous than some other drugs which people get concerned about, like statins." 

In this article, we’ll look at both the benefits and the risks associated with aspirin. 

Aspirin: One Of The World’s Most
Widely Used Drugs

German research chemist Felix Hoffman developed aspirin while working for the pharmaceutical company Bayer, in 1897. 

He did it, by developing a process to synthesize acetylsalicylic acid (ASA) - a synthetic derivative of a compound called salicin.

Salicin is found in nature in plants like the willow tree. 

Early studies found aspirin to be extremely effective for the treatment of pain, fever and inflammation.2 With the mechanism of these benefits appearing to be the inhibition of pain producing chemicals called prostaglandins.

Because of these benefits, aspirin has often been used to treat a variety of common ailments. 

Including things like headaches, muscle pain, toothaches and joint pain. 

In recent years, researchers have also discovered that aspirin may be used as a blood thinner. 

This can help reduce the formation of blood clots, through its inhibition of a prostaglandin called thromboxane, which plays an important role in formation of blood clots.

Because of this, more recent studies have shown that aspirin may in fact lower your risk for heart attack and stroke. 

As such, many doctors often recommend it to their high-risk patients. 

Possible Uses For Aspirin

But, just like any drug, aspirin also brings with its many benefits a long list of possible side-effects too.

One of the most common and most severe side-effects is gastrointestinal bleeding, which can put you at risk of developing a stomach ulcer.3

And if you already have a stomach ulcer, taking aspirin can cause even more bleeding and it could even put your life at risk. 

Another potential threat is the fact that aspirin may also interact with other drugs that you may be taking, which can increase your risk of bleeding. This is particularly common with drugs that also have anti-clotting properties. Drugs like warfarin, apixaban and dabigatran. Even nutritional supplements like evening primrose oil and fish oil can increase your risk of bleeding when combined with aspirin.

Other studies have also found a connection between aspirin use and an increased risk of age-related macular degeneration. 

Plus, there are some people who are allergic to aspirin, people with asthma carrying the highest risk.

An allergic reaction to aspirin may cause swelling in the throat, mouth and lips. It can also cause breathing problems and a skin rash. 

Additional side-effects that have been reported include, bruising, headaches, nausea, vomiting and even tinnitus. 

Some studies have even linked aspirin to additional health problems. 

For example, previous research has shown that the use of aspirin is associated with Reye’s syndrome – a rare condition that causes swelling in the brain and liver and occurs most often in children and teens.4 

But even with these risks, aspirin has still become one of the most widely used over the counter drugs in the world. 

And people are using it for a variety of reasons, not just to relieve headaches or other aches and pains. 

In fact, aspirin is being used in efforts to prevent a variety of health conditions. 

Aspirin For Heart Health?

Earlier we discussed aspirins role in preventing blood clots.

Recently, Medical News Today wrote about a study done by a group of Australian researchers who looked at people with venous thromboembolism (VTE) - a condition comprised of deep vein thrombosis (blood clots in the legs) and pulmonary embolism (in which a blood clot breaks off and travels to the lungs) – when these individuals were given a 100-mg dose of aspirin daily their blood clot recurrence rate was reduced by 42%.5

This study, along with others showcasing the anticoagulant properties of aspirin have led many heart health experts to recommend daily aspirin therapy to their patients. 

Even the American Heart Association (AHA), recommends daily low-dose aspirin – monitored by a health care provider - for individuals who have previously suffered a heart attack or those at high risk.

Just recently, new guidelines were issued by the US Preventive Services Task Force (USPSTF) recommending that people between the ages of 50-59 who are at high risk for cardiovascular disease take a low-dose aspirin daily. 

However, the debate as to whether this is a helpful practice or not continues. 

In a statement released by the US Food and Drug Administration (FDA) they concluded that while daily aspirin use can help prevent heart attack and stroke in high-risk individuals, there is insufficient evidence to suggest it is beneficial for primary prevention.6

Regardless, a recent study reported in Medical News Daily showed that 1 in 10 patients in the United States are inappropriately receiving daily low-dose aspirin in efforts to prevent a first heart attack or stroke. 

The author of the first study Dr. Ravi S. Hira, of the Baylor College of Medicine in Houston, TX, expressed concern over these findings, due to the potential risks associated with daily aspirin use. 

"Major coronary events are reduced 18% by aspirin, but at the cost of an increase of 54% of major extracranial bleeding," he explained. "Each two major coronary events have shown to be prevented by prophylactic aspirin at the cost of one major extracranial bleed. Yet, primary prevention with aspirin is widely applied." 

To make matters worse, some studies have even shown a link between regular aspirin use and an increased risk of hemorrhagic stroke - a type of stroke caused by a blood leakage in the brain. 

Aspirin And Its Effect On Cancer

There’s a reason why the largest clinical trial to assess aspirin’s potential role in fighting cancer is about to begin. It’s because there is an abundance of evidence claiming aspirin has cancer fighting capabilities.  

Medical News Today recently reported on a study published in the Journal of the National Cancer Institute. In the study researchers found that aspirin may in fact reduce the risk of ovarian cancer by as much as 20%. 

A more recent study associated long-term use of low-dose aspirin to a lower risk of colorectal cancer or bowel cancer. 

In addition, a study presented at the 2015 European Cancer Congress in Vienna, Austria, made the suggestion that aspirin could in fact double the survival rate for patients with gastrointestinal cancers. 

These are just a few examples of the many studies that have made the assertion that aspirin possess anti-cancer properties. And its studies like these that are fueling the excitement and the anticipation for the new study.

"There's been some interesting research suggesting that aspirin could delay or stop early-stage cancers coming back but there's been no randomized trial to give clear proof," says Prof. Ruth Langley, of Cancer Research UK, who is heading the new trial. "The trial aims to answer this question once and for all." She adds: "If we find that aspirin does stop these cancers returning, it could change future treatment - providing a cheap and simple way to help stop cancer coming back and helping more people survive."

And while a positive result is anticipated from this trial, many researchers still have concerns surrounding the daily use of aspirin and its role in cancer prevention. 

Here’s why, in a previous study published in JAMA researchers found that regular aspirin use may in fact, increase the risk of bowel cancer for some people. This appeared to be related to specific genetic variants. 

The authors of the study suggest that their findings show the importance of identifying which people are more likely to benefit from regular aspirin use with regards to a reduced risk of bowel cancer. 

"Validation of these findings in additional populations may facilitate targeted colorectal cancer prevention strategies," they noted. 

Aspirin And Pregnancy

Recently, researchers have suggested that they may have found a link between the use of daily aspirin and the possibility of an increased chance of conception.

Medical New Today was among the first to report on this connection. 

They referenced a study published in The Lancet that found women who had a history of miscarriages or stillbirths, had a greater chance of a successful pregnancy if they took 81 mg of aspirin daily with folic acid, compared with women who took a placebo. 

In a different study of more than 1200 women, presented at the American Society of Reproductive Medicine’s Annual Meeting in Baltimore, MD - women who took 81mg of aspirin daily were 17% more likely to become pregnant and 20% more likely to have a successful birth than those who did not take the drug.7

While it’s not completely understood how aspirin increases a woman’s chances of pregnancy, researchers are speculating that the reduction of system-wide inflammation may have something to do with it. Less inflammation may make the womb safer for a growing embryo, they speculate. 

Researchers also believe that aspirin may also increase blood flow to the pelvic region, thickening the lining of the womb which can make it easier for the embryo to implant. 

Because of these findings, many doctors are beginning to recommend regular aspirin use in efforts to boost fertility. 

"Aspirin is the drug of the millennium," says Dr. Richard Paulson, professor of obstetrics and gynecology at the University of Southern California Keck School of Medicine. "There is no harm in women wanting to get pregnant taking aspirin. Many people use it routinely, including in our clinics. We have been doing this for many years." 

However, there are still other health experts who believe the risks associated with regular aspirin use – like internal bleeding – far outweigh any positive benefits. 

"I don't think women trying to get pregnant should take an aspirin every day. The evidence does not support the need," Edgar Mocanu, treasurer of the International Federation of Fertility Societies (IFFS), told a major news source earlier this month.

Discuss The Benefits And Risks
With Your Doctor

Several studies appear to show some positive benefits from regular aspirin use, so much so that many health care providers are convinced that their patients should be taking it daily. 

"This is clear-cut. Aspirin is cheap and effective,'' Peter Elwood, professor of epidemiology at the UK's University of Wales, told a major news source. "Taking aspirin every day will increase your chance of survival against serious diseases.'' 

Regardless, most will agree that you should first consult your physician prior to starting a daily aspirin regimen. 

Dr. Phil Hammond, a general practitioner in the UK, recently told reporters:

“Note, all drugs that have effects also tend to have side effects. Some can't be predicted, but some people are at higher risk of side effects from aspirin and probably do need to share the decision to take it with a doctor or pharmacist - even if you are just taking it for pain relief."

The fact is, there are some people who are at higher risk for side effects due to regular aspirin intake. 

Those people include pregnant women and people who have high blood pressure, asthma, liver or kidney problems, a blood disorder or allergies to any other medications. 

In addition, aspirin should also not be given to children under the age of 16 due to the increased risk of Reye's syndrome. 

If you are currently taking aspirin regularly, the FDA recommends reducing your alcohol intake due to the increased risk of stomach bleeding. 

It’s also recommended that anyone undergoing surgical or dental procedures should also inform their surgeon or dentist if they are taking aspirin regularly, due to the increased risk for bleeding during surgery. 

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References:

1. "Home | Add-Aspirin." Add-Aspirin. N.p., 2018.

2. Justin Choi, MD. "Aspirin: Health Benefits, Uses, And Risks." Medical News Today. N.p., 2017.

3. Huang, Edward S. et al. "Long-Term Use Of Aspirin And The Risk Of Gastrointestinal Bleeding." The American Journal of Medicine 124.5 (2011): 426-433.

4. Hall, Susan M. "Reye's Syndrome And Aspirin: A Review." Journal of the Royal Society of Medicine 79.10 (1986): 596-598.

5. "Aspirin Can Prevent Recurrent DVT And PE." Patient Education Blog | Clot Connect. N.p., 2014.

6. "Can An Aspirin A Day Help Prevent A Heart Attack?." Fda.gov. N.p., 2014.

7. Gregory, Andrew. "A Daily Aspirin Can Help Women Get Pregnant, Top Fertility Doctor Claims." mirror. N.p., 2015.

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