Will taking an aspirin a day save YOUR life?
Last updated at 9:01 AM on 31st May 2011
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It was taken to the Antarctic by Captain Scott, to the top of Mount Everest by Edmund Hillary and to the Moon by the Apollo astronauts.
Closer to home, you’ll also probably find it in every GP’s bag, since it is a known life-saver in the event of a heart attack.
Low-dose aspirin has been shown to reduce the risk of a second heart attack and other conditions including Alzheimer's disease, depression and various cancers
For most of the 20th century, it was considered one of the most successful painkilling and anti-rheumatic drugs, yet many people seem reluctant to use it.
Sometimes this is due to reported side-effects such as gastric irritation and stomach ulcers.
For others, the fact that aspirin is so readily available without the need for a doctor’s prescription, and so cheap, has made them regard it as little more than a household remedy and assume it is of less benefit than a more expensive tablet.
The fact is that this small, white, unassuming tablet could be a veritable life-saver. Low-dose aspirin has been shown not only to reduce the risk of a second heart attack, but also a variety of other conditions including Alzheimer’s disease, depression and various cancers.
It’s also thought to have a role in reducing the risk of complications in diabetes.
Aspirin appears to work by reducing inflammation in the body that damages cells and tissues. It does this by preventing the action of two enzymes in the body called COX-1 and COX-2, which normally spark inflammation.
However, another role of COX-1 is to protect the stomach and intestines from stomach acid damage, hence the side-effects of aspirin which include gastric bleeding, stomach ulcers and heartburn.
So should you be taking a daily aspirin?
To help you decide, I have looked at the research from more than 60 studies, covering hundreds of thousands of patients and a range of conditions. (Remember, you should never start taking a daily aspirin without first consulting your doctor.) Here is what I’ve found...
CANCER
The idea that aspirin can play a part in preventing some cancers has emerged from several lines of research.
For instance, at the end of last year two major papers published in The Lancet (involving more than 20,000 patients followed for 20 years) showed the overall cancer death rate was reduced by 34 per cent after five years of aspirin use.
Studies suggest the effect might be due to aspirin’s ability to reduce levels of inflammation and COX-2. Raised levels of COX-2 have been found in cancerous tissue, and animal studies have shown that treatment with COX-2 inhibitors reduced tumour formation and growth.
The risk reduction was greater in certain cancers, in particular gastrointestinal, for which death rates were reduced by 54 per cent.
The Lancet studies also found a 20 per cent drop in deaths from prostate cancer, 30 per cent for lung cancer, 40 per cent for colorectal cancer and 60 per cent for oesophageal cancer.
Another study, of 37,000 women and published in the International Journal of Clinical Practice, suggested aspirin use could reduce the risk of breast cancer by 20 per cent.
A separate study of more than 4,000 women, published in 2010, suggested that in patients with breast cancer, aspirin reduces the risk of the cancer spreading by 43 to 60 per cent, and there was also a 64 to 71 per cent reduction in the risk of breast cancer-related death.
The bottom line: Taking aspirin long term is linked to an overall reduction in the risk of several cancers, with the following points worth noting:
- The effect takes five years to become apparent, though the longer the usage, the greater the reduction in risk: 20 to 25 years of usage gives the best protection. After that, there may be more risk of haemorrhages;
- Low-dose aspirin — 75mg — seems enough to produce the effect;
- The peak time to start in order to reap the benefit seems to be when patients are in their late 40s and 50s;
- When it comes to breast cancer, there is not yet enough research to suggest that well women should put themselves at risk of having an aspirin-related bleed in order to reduce their risk of breast cancer, nor is its use as a treatment for breast cancer patients recommended.
DEPRESSION
There is not yet enough evidence to say you should take aspirin to reduce the risk of depression, but the idea is certainly worthy of further research
Some researchers believe depression and inflammation might be linked after small studies showed some people with depression have high levels of cytokines — naturally occurring inflammatory chemicals.
As an anti-inflammatory drug, aspirin might, therefore, be able to prevent depression or reduce its intensity.
One study followed 386 women for ten years — 22 developed depression after the age of 50.
Only one of this depressed group had taken aspirin, said the researchers writing last year in the Journal of Psychotherapy and Psychosomatics. But in the group who hadn’t developed depression, almost a third were taking it. The authors concluded that there is a highly significant reduction in risk of depression from taking aspirin.
The bottom line: There is not yet enough evidence to say you should take aspirin to reduce the risk of depression, but the idea is certainly worthy of further research.
But never combine aspirin with antidepressants without first consulting your doctor, as they can interact and increase the risk of bleeds.
HEART DISEASE
Aspirin is thought to help by reducing inflammation in the artery that supplies the heart, making the blood less likely to become sticky and form a deadly clot.
In some studies, taking aspirin reduced the likelihood of a cardiovascular problem (heart disease, heart attack or stroke) in patients at high risk by as much as 44 per cent.
In those who had already suffered a heart attack or an ischaemic stroke (caused by a blood clot in the brain), a daily low dose of aspirin cut the risk of having a further heart attack or stroke by as much as 33 per cent.
The bottom line: Taking aspirin reduces the likelihood of a cardiovascular problem for patients at high risk — whether they’ve already had a heart attack or stroke or not.
For these patients, the risks of suffering from a side-effect of aspirin (such as a bleed) are less than the risks of non-treatment.
It is not clear if aspirin reduces heart attack risk in people who are only at low risk. Any benefit would have to be balanced against the risk of possible side-effects.
DEMENTIA
Scientists have discovered that levels of the COX-2 enzyme are found to be raised in certain parts of the brains of people with Alzheimer’s. Studies suggest that Alzheimer’s disease, the most common form of dementia, might be an inflammatory condition, so it makes sense that an anti-inflammatory drug such as aspirin would be effective in treating it.
However, there is conflicting evidence about aspirin’s power against this disease.
Some, such as the 2002 Cache County Study of more than 3,000 people, is very positive and suggests that aspirin and other anti-inflammatory medications could reduce the risk by 23 per cent. Others, such as The Women’s Health Study with 6,000 women monitored for ten years, suggest no effect.
The bottom line: Although we can’t draw a definitive conclusion from the research, there is certainly enough positive evidence for a discussion with a GP about whether aspirin would be a sensible drug for anyone who is concerned about their risk of developing Alzheimer’s disease.
However, for any benefit it seems aspirin has to be taken long term, for at least five years, and before the onset of dementia.
Aspirin might also have a part to play in the prevention of vascular dementia (caused mainly by strokes) by reducing the risk of blood clots.
SKIN PROBLEMS
Aspirin can help skin complaints when its key ingredient — salicylic acid — is rubbed on to it in the form of a specially prepared cream or other product.
This compound softens the skin by breaking down the tough outer layer, allowing the dead skin to be shed.
Salicylic acid also has a slight anti-inflammatory effect. Products for topical use that contain it include Lassar’s paste (a long-standing treatment for psoriasis) and salicylic acid and sulphur shampoo (used for dandruff and itchy scalp conditions).
The bottom line: It can help with a range of conditions, including psoriasis, corns, warts, verrucas, itchy scalp conditions and some types of eczema. But anyone with an allergy to aspirin or any other contraindications should not take it, even for external use.
IT CAN EVEN TREAT YOUR DANDRUFF
Aspirin dissolved in water and applied to the skin has been said to help with the following problems.
DANDRUFF: A common cause of dandruff is a tiny yeast called Pityrosproum ovale which lives on the scalp. Aspirin is a mild anti-fungal and can reduce the numbers of this micro-organism. Dissolve one 75mg tablet in a little water and mix with your normal shampoo two or three times a week.
INSECT BITES/BLEMISHES: An aspirin paste (one 75mg tablet crushed with a teaspoon of water) may help soothe bites and shrink spots. Leave for two minutes then wash off with cool water. This can be repeated after four hours. However this treatment should not be used for those with acne; see your GP for more effective treatments.
HARD SKIN: Aspirin can soften skin, making calluses easier to remove. Crush four 75mg tablets in a tablespoon of water to make a paste. Soak this onto a flannel and apply to the callus. Leave for about ten minutes, then remove, wash and dry. Gently pumice the area. Do this on a daily basis for a week.
note: Anyone with an allergy to aspirin or any other contraindications should not use aspirin, even for the above external uses.
Dr Souter worked as a GP in Wakefield for nearly 30 years. Adapted from An Aspirin A Day, by Dr Keith Souter, published by Michael O’Mara Books on Thursday, at £7.99.
© 2011 Dr Keith Souter. To order a copy for £7.49 (incl p&p), call 0843 382 0000.
(source: dailymail.co.uk/health/article-1392566/Aspirin--taking-day-save-YOUR-life.html#ixzz1NzGdm0RR)
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