Should you take aspirin?

Q. I’m 38 years old and healthy. I exercise three times a week. I read about the benefits of aspirin on the Internet. I’m thinking if I should take it? — Jed

A. Yes, Jed, aspirin is indeed a wonderful drug and it has been shown to prevent heart attacks and stroke. Very effective. However, not every person will benefit as much from it. There’s more to taking aspirin than meets the eye.

Did you know that an American doctor recently warned against the over the counter use of aspirin, saying there is great potential for abuse? And it is here that we must carefully weigh the benefits and risks of taking aspirin.

• Who will benefit from aspirin?

If you fall in the category of a middle-aged male with heart disease (blockage of the arteries) then you need to take aspirin. Those with strokes, diabetes and high cholesterol may also need aspirin. But for the healthy and the young, the risks may be more than the benefits.

• What are the dangers of aspirin intake?

First, aspirin or acetylsalicylic acid is really an acid, so it can erode the lining of the stomach and cause serious bleeding. Dr. Virgilio Banez, a fellow of the Philippine Society of Gastroenterology, believes that Filipinos are more prone to bleeding ulcers from aspirin intake as compared to Caucasians. There has even been a report of a single aspirin tablet perforating the stomach!

Another potentially fatal side effect is brain hemorrhage or bleeding in the brain. Aspirin is a blood thinner and interferes with the normal clotting mechanisms of the body. It can cause bleeding and bruises. That is why doctors advise their patients to stop taking aspirin for seven days before a surgical or dental operation. And on rare occasions, there are those allergic to aspirin.

• What are the benefits of aspirin?

Hopefully, I haven’t scared you that much with the risks mentioned. Now, let’s look at the health benefits. Aspirin has been proven time and time again to prevent heart attacks and strokes. Recently, studies suggest that aspirin may also prevent some cancers of the intestine. And its greatest advantage, of course, is the affordable cost, only P1 to P2 per tablet.

• What’s the final judgment?

In a reputable combined analysis (called meta-analysis) of all the positive and negative aspirin data published in the last century, doctors came up with the following conclusions:

1. Aspirin is beneficial for patients who have suffered a heart attack or a stroke.

2. Aspirin is beneficial for patients with diabetes, heart disease, high cholesterol levels and those with controlled high blood pressure.

3. Aspirin is harmful for patients with peptic ulcer disease, gastritis and aspirin allergy.

Now, if you fall somewhere in-between the above categories. Thus, the merits of aspirin intake are less certain. It is safer to consult your doctor first.

• What dose of aspirin is best?

Years ago, aspirin was given as high as 1,600 mg per day while more recent studies suggest that a dose as low as 30 mg may already provide heart protection. For Filipinos, 80-100 mg of aspirin is the usual dose. In the end, your doctor may prescribe higher or lower doses depending on your risk factors.

• Are there alternatives to aspirin?

Ginkgo biloba has a blood-thinning effect similar to aspirin. The ornamental tree Ginkgo biloba came from China thousands of years ago. It has been reported in scientific journals to enhance blood circulation and to increase oxygen supply to the brain and heart. A study in the Journal of the American Medical Association also showed that ginkgo has some beneficial effect on dementia in people with Alzheimer’s disease. However, Ginkgo and aspirin do not add up well because the combination of these drugs may cause internal bleeding.

Another alternative to aspirin is the drug clopidogrel. The reputation of this drug is quite good and it is less irritating to the stomach. So why not just take it? Well, each 75 mg tablet costs more than P100, and this drug alone will cost you P40,000 per year. It can make even a millionaire bleed.

But the good news I heard is that the generic form of clopidogrel may soon be available at half the price. Hopefully,  this will come sooner than later. Too many sick and poor people are dying, if you ask me.

In conclusion, Jed, I think you’re OK. No need to take aspirin for the moment and just continue with your healthy lifestyle. And it’s nice to thank God once in a while for the great gift He gave to many of us including you — the gift of good health.

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For your questions, send e-mail to willietong@gmail.com.