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Preventive Cardiology: Aspirin

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Drug InteractionsNutrient/Supplement InteractionsOther Potential ConcernsWhat to Watch For


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Medication (name): Aspirin

Commonly Used Brand and Generic Names:

Generic name: acetylsalicylic acid
Common brand names: Bayer, Bufferin, and many others
General category: Blood thinner, nonsteroidal anti-inflammatory drug (NSAID), salicylate

Current Uses

Aspirin is used to treat and prevent a range of conditions. This medicine may be taken for:
  • Pain relief
  • Fever reduction
  • Reducing the risk of dying when having a heart attack
  • Preventing a heart attack or stroke
There is promising evidence to support that taking an aspirin every day is associated with a reduced risk of dying from cancer after it has been diagnosed.

Recommendations

To prevent cardiovascular disease, the US Preventive Services Task Force (USPSTF) recommends daily aspirin. Aspirin is recommended for men aged 45-79 years and women aged 55-79 years as long as the benefits of taking the medicine outweigh the risks. One common risk to consider is gastrointestinal bleeding. If you want to start taking aspirin every day, be sure you talk to your doctor first to make sure that it is safe for you.
The American Heart Association recommends aspirin for certain poeple who are at high risk of heart attacks and for poeple who have experienced a myocardial infarction (heart attack), stroke, or transient ischemic attack (mini-stroke) if not contraindicated.
Take only the amount of aspirin instructed by your doctor. If you are taking aspirin regularly and you need a medicine to relieve pain, a fever, or arthritis, your doctor may not want you to take extra aspirin. It is a good idea to discuss this with your doctor, so that you will know ahead of time what medicine to take.
Do not stop taking this medicine for any reason without first checking with the doctor who directed you to take it.

Mechanism for How It Works

  • Analgesic/Anti-inflammatory, nonsteroidal —This inhibits the body’s production of a hormone-like substance called prostaglandin. This chemical causes pain by stimulating muscles contractions and blood vessel dilation. Aspirin may also fight inflammation in a plaque caused by atherosclerosis .
  • Antithrombotic (blood thinning)/Platelet aggregation inhibitor —This prevents platelets from releasing the prostaglandin thromboxane, which causes platelets to clump together in a blood clot. This helps prevent potentially fatal formation of new blood clots in diseased blood vessels.

Side Effects

Drug Interactions

Aspirin can interact with many types of medicines. Some examples include:
  • Blood thinners
  • Oral medicines used to treat diabetes
  • Anticonvulsants
  • Beta-blockers
  • Corticosteroids
  • Other nonsteroidal anti-inflammatory medicines
  • Diuretics
Be sure to talk to your doctor about the specific medicines that you are taking.

Nutrient/Supplement Interactions

There are many types of herbs and supplements that can interact with aspirin. Examples include:
To avoid any interactions, it is important that you talk to your doctor about any herbs are supplements that you are taking before you begin aspirin therapy.

Other Potential Concerns

If you have one of the following conditions, it may not be appropriate for you to take aspirin due to the increased risk of complications:
  • Liver or kidney disease
  • Peptic ulcer or other gastrointestinal bleeding disorder, or those at risk for these disorders
  • Allergy or intolerance to aspirin or other nonsteroidal anti-inflammatory drugs
  • Hemophilia or other bleeding problems—the chance of bleeding may be increased
  • Gout —salicylates can make this condition worse and can also lessen the effects of some medicines used to treat gout
  • Syndrome of asthma, rhinitis, and nasal polyps
  • Children and adolescents with a viral infection
  • Pregnant or lactating women
Low-dose aspirin increases risk for gastrointestinal bleeding and hemorrhagic stroke. Do not use without medical advice if you are at increased risk for these diseases.

What to Watch For

Examples of common side effects include:
  • Stomach irritation
  • Nausea/vomiting
  • Increased bleeding
Serious side effects to watch for include:
  • Signs of bleeding in the gut such as vomiting blood or blood in the stool
  • Allergic reaction to aspirin

RESOURCES

American Heart Association http://www.heart.org/HEARTORG/

US Food and Drug Administration http://www.fda.gov/

CANADIAN RESOURCES

American Academy of Family Physicians http://www.aafp.org/

Health Canada http://www.hc-sc.gc.ca/index%5Fe.html/

References

Antiplatelet agents for secondary prevention of stroke.http://www.ebscohost.com/dynamed/what.php. Updated December 14, 2012. Accessed December 14, 2012.

Aspirin. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed/what.php. Updated November 2, 2012. Accessed December 14, 2012.

Aspirin and Heart Disease. American Heart Association website. Available at: http://www.heart.org/HEARTORG/Conditions/HeartAttack/PreventionTreatmentofHeartAttack/Aspirin-and-Heart-Disease%5FUCM%5F321714%5FArticle.jsp. December 11, 2012. Accessed December 14, 2012.

Aspirin for Primary Prevention of Cardiovascular Disease. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed/what.php. Updated July 9, 2012. Accessed December 14, 2012.

Holmes MD, Chen WY. Hiding in Plain View: The Potential for Commonly Used Drugs to Reduce Breast Cancer Mortality. Breast Cancer Res. 2012;14(2):216.

McCowan C, Munro AJ, Donnan PT, et al. Use of Aspirin Post-Diagnosis in a Cohort of Patients with Colorectal Cancer and its Association with All-Cause and Colorectal Cancer Specific Mortality. Eur J Cancer. 2012;poo:S0959-8049912)00858-1.

Nonsteroidal Anti-Inflammatory Drugs. EBSCO Natural and Alternative Treatments website. Available at: http://www.ebscohost.com/healthlibrary/. Updated July 25, 2012. Accessed December 14, 2012.

Reimers MS, Bastiaannet E, va Herk-Sukel MP. Aspirin Use After Diagnosis Improves Survival in Older Adults with Colon Cancer: A Retrospective Cohort Study. J Am Geriatr Soc. 2012;60(12):2232-2236.

Revision Information

This content is reviewed regularly and is updated when new and relevant evidence is made available. This information is neither intended nor implied to be a substitute for professional medical advice. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with questions regarding a medical condition.

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