An Aspirin a Day ... or Not?
Aspirin's protective powers may now guard against cancer, too.
Those patients most in need of daily aspirin therapy are easy
to identify. If you have a documented personal or family history of heart
disease -- including heart attacks, stokes, or angina; if you have diabetes; or
if you have multiple risks for the development of heart disease such as have
high blood pressure, high cholesterol, or are a smoker, you should most likely
take a daily dose of aspirin (but always consult with your physician first).
Although the optimal dose of aspirin in prevention of future heart disease is
still unclear, doses of 75 milligrams, 100 milligrams, or 325 milligrams have
been found to be equally effective.
Studies reviewed by the U.S. Preventive Services Task Force
have shown that daily or every-other-day aspirin therapy reduced the risk of
coronary heart disease by 28%in persons who had never had a heart attack or
stroke, but who were considered high-risk individuals.
It's also pretty easy to identify those individuals who, in all
probability, don't need to take aspirin on a daily basis, Fendrick says.
Healthy people in their 20s and 30s, for example, with no cardiac risk factors
and no major risk factors for developing the other diseases aspirin can
prevent, such as certain cancers, should consider the risks of aspirin therapy
to outweigh the benefits.
But then there's a large group of people that fall into the
middle category -- the "probably-should-take" group. For these people,
individuals with a strong family history of colon cancer, for example, or
dementia, balancing aspirin's potential benefits against its well-documented
risks can be a very complicated equation. "The benefits of aspirin for
preventing colon cancer, dementia, and heart attacks need to be carefully
weighed by a medical professional against the potential for serious
complications," says Dr. Fendrick.
The FDA also provides a fact sheet on deciding whether or not
daily aspirin therapy is right for you (it's specific to heart disease) on its
More Isn't Always Better
If you and your doctor decide you should be taking aspirin
daily, the next question is, "How much?" In the land of the super-size,
is it any wonder that we think that if one pill is good, two must be better,
and if 100 milligrams may help prevent cancer, 200 or 300 milligrams must have
twice or three times as much cancer-busting power? Stop right there.
Medications don't work that way, and especially in the case of aspirin and
other NSAIDs, a little goes a long way.