For decades, doctors have touted the benefits of low-dose aspirin as an effective way to decrease the risk for heart disease, stroke and certain cancers. But a new study adds to a large body of research that finds the risks associated with maintenance aspirin may sometimes outweigh the benefits — especially for women.
The paper, published Thursday in the journal Heart, is based on a randomized clinical trial that began in the 1990s and involved nearly 28,000 healthy women age 45 and older. The women were either given 100 milligrams of aspirin every other day or a placebo.
A decade and half later, the researchers found regular aspirin modestly reduce the risk for cancer and cardiovascular disease. In a 10-year period there were 604 cases of cardiovascular disease, 168 cases of bowel cancer and 1,832 cases of other cancers.
However, a sizable population of women in the study who took aspirin also suffered from gastrointestinal bleeding, a common side effect of long-term use. A total of 302 women in the study were hospitalized for major gastrointestinal bleeding.
“[The study] emphasizes a point,” health contributor Dr. David Agus told “CBS This Morning.” “There is a benefit and we need to personalize treatment. You’ve got to look at your risk and your benefit and make the right decision. But I am a believer in prevention.”
He added that solutions some health care providers have suggested, such as taking coated aspirin, may have a benefit although they weren’t examined in this particular study. A patient and their doctor should take into account their family history of heart disease and cancer before making a decision to take a baby aspirin every day.
Even medical organizations that have typically advocated for use of this maintenance drug now recommend more prudent measures. The American Heart Association and American Cancer Society do not recommend aspirin for everyone with a increased risk for either or both diseases. The U.S. Preventive Services Task Force does recognize the benefits of maintenance aspirin for men age 45 to 79 and women age 55 to 79, but only after weighing the risk for gastrointestinal bleeding.
According to the U.S. Department of Health and Human Services, prevention studies have shown that aspirin reduces the relative risk for heart attack by 32 percent in men and reduces the risk for stroke by 17 percent in women.
A study published earlier this year found 75 to 80 milligrams of aspirin a day lowered the risk for bowel cancer by 35 percent and deaths from the disease by 40 percent. The risk of esophageal and stomach cancers are reduced by 30 percent.
Aspirin works by blocking inflammation, which more studies show is the root cause of heart disease and cancer. “Inflammation — it’s like FEMA –is a big response element,” Agus said. “But at the same time it can cause damage, and by tempering that damage with a low-dose aspirin everyday, we can significantly reduce disease.”