Aspirin: Always Risk vs. Reward

Researchers have published the most comprehensive review of the benefits and risks of a daily dose of prophylactic aspirin.

Benefit needs to be balanced alongside a fuller understanding of the potentially harmful side effects.

The paper, published by the National Institute for Health Research Health Technology Assessment (NIHR HTA) Programme, reported benefits of taking aspirin each day ranged from 10% reduction in major cardiovascular events to a 15% drop in total coronary heart disease. In real terms, that would ultimately mean 33-46 fewer deaths per 100,000 patients taking the treatment.

There was also evidence of a reported reduction in incidents of colorectal cancer, which showed from approximately five years after the start of treatment. This would equate to 34 fewer deaths from colorectal cancer per 100,000 patients.

The adverse effects of aspirin were also noted with a 37% increase in gastrointestinal bleeding (an extra 68-117 occurrences per 100,000 patients) and between a 32%-38% increase in the likelihood of a hemorrhagic stroke (an extra 8-10 occurrences per 100,000 patients).

The researchers said, "This study makes it clear that there is an incredibly fine balance between the possible benefits and risks of the intervention. We need to be extremely careful about over-promoting aspirin intervention without having first fully understood these negative side effects.

Steve: For our clients considering aspirin, we always state that getting a genetic screening for tolerability is paramount. This can easily be done but is very rarely offered by physicians.