Aspirin: What are the Benefits, What are the Risks?
© 2019 Health Realizations, Inc. Update
The first form of aspirin -- today one of the most widely used drugs around -- existed all the way back in the 5th century B.C., when the father of medicine, Hippocrates, used willow bark and leaves to relieve pain and reduce fever. It wasn't until the 1820s, however, that scientists identified the active component in willow bark: salicin.
Salicylic acid derived from willow bark worked to fight aches and pains, but there was a major drawback: it upset the stomach. So, a few decades later, French chemist Charles Frederic Gerhardt found that combining salicylic acid with acetyl chloride made it less irritating.
Aspirin can be purchased for pennies a day, but some believe this easy access makes consumers overlook its potentially serious risks.
But Gerhardt, thinking the compound was too complex to make, abandoned the idea. It wasn't until 1899, when Felix Hoffmann, a German chemist, came across Gerhardt's recipe and found the compound really worked, that aspirin came to be.
Hoffmann worked for Bayer and convinced the company to make the drug, named Aspirin (the names comes from acetyl chloride [A] and spiraea ulmaria, the plant that salicylic acid comes from [spir] along with an [in] ending).
Bayer released Aspirin tablets in 1915 (it was previously sold as a powder), but, interestingly, had to give up the trademark after World War I as part of Germany's war reparations. At the Treaty of Versailles, the trademark (along with the trademark for Heroin) was given to France, England, Russia and the United States.
Today aspirin is a household word, and while some believe it should retain its reputation as a miracle drug, others think aspirin may not be as safe or worthwhile as it's touted to be.
Aspirin: "The Wonder Drug"
Among aspirin's most prized effects is its ability to thin the blood and make it less sticky. Studies have found that aspirin keeps blood from clotting, thereby reducing the risk of heart attack and stroke. And, if taken during an attack, aspirin has been found to reduce the severity.
But that's not all. "The benefits of aspirin go beyond the cardiovascular system. There is solid evidence that aspirin slows the progression of colon cancer, and some preliminary data suggests that regular aspirin use may prevent certain cancers from occurring at all," says A. Mark Fendrick, M.D., an internist at the University of Michigan Health System. "Also population-based studies report that an aspirin a day will either slow the progression or even prevent dementia, such as Alzheimer's disease."
"Because it's been around so long and is available over the counter for pennies a day, many people can't believe that aspirin is equally or more effective than prescription drugs that cost over a hundred times more," Fendrick says.
Other conditions aspirin has been found to benefit include migraine headaches, cataracts, gum disease, pre-eclampsia (high blood pressure during pregnancy) and preventing blood clots in veins during long plane trips.
Aspirin Has Serious Side Effects
With all of these benefits, one gets the impression that most everyone could benefit from popping an aspirin daily. And while the general consensus is that people who have heart disease or have had a heart attack in the past very well could benefit from regular low-dose aspirin, and certainly anyone having a heart attack could benefit from quickly swallowing the drug, the advice for healthy individuals is not so clear cut.
"Although taking aspirin leads to a wealth of potential health benefits for adults, people should realize that even a baby aspirin is not free of dangerous side effects," Fendrick said.
Aspirin should not be given to children and teenagers because of the risk of Reye's Syndrome, a potentially fatal disease.
The risks must be weighed against the potential benefits, and, according to the Food and Drug Administration's Center for Drug Evaluation and Research, "the risks of long-term aspirin use may be greater than the benefits if there are no signs of, or risk factors for, heart or blood vessel disease."
Most people are aware that aspirin can cause stomach upset, heartburn, nausea and vomiting, but there are also more serious risks, such as:
Stomach bleeding, ulcers and holes in the stomach
Bleeding in the brain and other internal bleeding
Certain types of stroke
Liver damage in chronic alcohol users
Ringing in the ears and hearing loss
Allergic reactions (in about two out of 1,000 people who are allergic to aspirin, the drug can cause facial swelling and asthma attacks, according to the Mayo Clinic)
Reye's Syndrome, which can occur when children take aspirin to reduce fever caused by a viral infection, is another concern. Although rare, the disease is very serious. Reye's Syndrome causes brain swelling and fatty deposits in the liver, and can lead to permanent brain damage or death.
Should You Take Preventative Aspirin?
Only you can decide, along with the guidance of a health care professional, whether regular low-dose aspirin is for you. Most experts agree, however, that those who stand to benefit most from regular aspirin use are those who:
Have a personal or family history of heart disease
Have risk factors for heart disease, such as diabetes, high blood pressure or high cholesterol
Taking aspirin for other reasons, including colon cancer, heart attack and dementia prevention, is much more questionable, and the risks must be assessed against the potential benefit. Generally speaking, those who are healthy and have a low risk of heart disease are not advised to take aspirin regularly, as the risks outweigh the benefits.
There are also certain groups that should definitely avoid aspirin, and this includes:
Children under 16
People with uncontrolled high blood pressure, liver or kidney disease
People with stomach ulcers, heartburn or upset stomach
People who have asthma
People who have bleeding problems
Anyone taking a drug for anticoagulation (blood thinning), diabetes, gout or arthritis
Possibly those who drink more than three alcoholic drinks per day
Women who are pregnant or nursing (it's especially important to avoid aspirin during the last three months of pregnancy)
FDA: Center for Drug Evaluation and Research
Aspirin: What Does it Have to do With the Treaty of Versailles?
University of Michigan Health Minute