Should we be taking aspirin

Should we be taking aspirin?

Even though doctors have been recommending patients to take aspirin for many decades, there is still considerable uncertainty on whether we should be making this recommendation, and if so to whom, and what dose?

A recent study suggested that perhaps when people were larger they needed more aspirin, rather than the conventional dose of 100 mg. Two large papers coming from Europe (one involving more than 15,000, and the other more than 12 a half thousand people) have fortunately clarified the situation and confirmed that 100 mg is fine. (More greatly increases the risk of stomach bleeding, with little or no benefit). Large and small people should all take the same dose (100mg).

Primary prevention – people with no evidence of heart disease, we don't have enough evidence to suggest that this is beneficial, and the risk of stomach bleeding is far greater than any possible benefit. Sadly the studies do not confirm that aspirin has any benefit in preventing cancer. Conclusion - don't take aspirin as a preventative.

Those at higher risk – i.e. people with diabetes or family history, again we don't have enough evidence to suggest that this is necessary or beneficial.

People with established heart disease – the data suggests that taking aspirin does reduce the risk of further heart events by about 12%, and I don't think is any doubt that unless there is some contraindication, people who have angina or a heart attack, had angioplasty or bypass surgery should be taking 100 mg of aspirin.  There is a slight increase in the risk of bleeding (usually from the stomach of between 0.5 and 0.9%)