Taking Aspirin Everyday: Can It Be a Life Saver?

Along with anti-inflammatory and analgesic properties, aspirin can be helpful in improving other cardiovascular health conditions.
If you have had a heart attack or stroke, a daily low dose of aspirin to help prevent another. Aspirin is part of a well-established treatment plan for people with a history of heart attack or stroke.
Take daily low-dose aspirin after talking to your primary health care professional. The risks and benefits vary for each person.

What is Aspirin?

Aspirin is a commonly used over-the-counter painkiller drug. It belongs to the group of drugs called non-steroidal anti-inflammatory drugs.¹
Aspirin is also known as acetylsalicylic acid. It is a medication commonly used to reduce pain, fever, or inflammation. It was initially derived from the bark of the willow tree and has been used for centuries to treat various ailments.
Aspirin is a generic name, and it is available in several different brands such as Bayer.

How Does Aspirin Work?

Aspirin works through the inhibition of an enzyme called cyclooxygenase (COX). There are two types of cyclooxygenase enzymes: COX-1 and COX-2. Aspirin inhibits both enzymes, which play critical roles in the production of prostaglandins. Prostaglandins are lipid compounds that have several important functions in the body, including mediating inflammation, pain, and fever.

• COX-1 Inhibition: By inhibiting COX-1, Aspirin reduces the production of protective prostaglandins in the stomach lining, which can sometimes lead to stomach ulcers or gastrointestinal bleeding.
• COX-2 Inhibition: By inhibiting COX-2, Aspirin reduces the inflammatory process and helps alleviate pain and fever.

What are the Uses of Aspirin?

The US Food and Drug Administration approved Aspirin for many different indications, such as:

• Temporary relief of minor aches and pains.
• Strokes or ischemic stroke to prevent subsequent cardiovascular events or death. 
• To reduce the risk of death in people with suspected acute heart attacks (myocardial infarctions)
• To prevent recurrent heart attacks
• To reduce the risk of heart attacks or sudden death in people with unstable and chronic stable angina pectoris (chest pain).
• Other coronary conditions such as such as angioplasty and coronary bypass operations 
• To relieve the signs and symptoms of different arthritis, including rheumatoid arthritis, juvenile rheumatoid arthritis, osteoarthritis, spondyloarthropathies, and arthritis and pleurisy associated with systemic lupus erythematosus. 
• Anti-inflammatory
• Antipyretic (fever-reducing)

How Does Aspirin Protect Heart Health?

Other NSAIDs such as acetaminophen, ibuprofen, naproxen sodium and ketoprofen are good drugs for pain and fever. However, Aspirin has demonstrated a beneficial effect in preventing another heart attack or stroke in people who have cardiovascular disease or who have already had a heart attack or stroke.

It plays a crucial role in cardiovascular protection, mainly through its antiplatelet effects. When platelets in the blood clump together, they form clots that can block blood vessels. It can lead to severe cardiovascular events such as heart attacks and strokes.

Aspirin inhibits platelet aggregation by blocking the action of COX-1, which is necessary for the synthesis of thromboxane A2, a potent promoter of platelet clumping. By reducing thromboxane A2 production, Aspirin decreases the tendency of platelets to stick together, thus reducing the risk of clot formation.²

In individuals who have had a previous heart attack or who are at high risk for a heart attack, low-dose Aspirin can help prevent future events by keeping the blood vessels open and preventing clot formation.

Can Aspirin Help to Prevent Stroke?

Aspirin’s role in stroke prevention is primarily linked to its antiplatelet effects, which help prevent the formation of blood clots that can block blood flow to the brain, causing an ischemic stroke. However, its usage must be carefully evaluated due to the potential risks associated with aspirin therapy.

Primary Stroke Prevention

Ischemic strokes (strokes due to lack of oxygen supply), which make up the majority of stroke cases, occur when a blood clot obstructs an artery supplying blood to the brain. By inhibiting the aggregation of platelets, Aspirin reduces the likelihood of these clots forming. It can be particularly beneficial for individuals who have already experienced an ischemic stroke or transient ischemic attack (TIA), often referred to as a “mini-stroke.”
The use of Aspirin in primary prevention—that is, in individuals who have not yet experienced a stroke or other cardiovascular event but are considered at risk—requires a subtle approach. The benefits of preventing stroke must be weighed against the increased risk of bleeding, including gastrointestinal bleeding and hemorrhagic strokes (due to bleeding).³

Secondary Stroke Prevention

In secondary prevention, for people who have had a previous stroke or TIA, low-dose Aspirin is commonly recommended to reduce the risk of another stroke. This secondary prevention strategy helps maintain adequate blood flow to the brain and prevents new clot formations.
For those at risk of ischemic stroke (caused by blood clots blocking blood flow to the brain), Aspirin’s antiplatelet effects help lower the likelihood of clot formation and improve blood flow, reducing the risk of another stroke.

Risk of Aspirin Use

While Aspirin offers significant benefits for cardiovascular health, it is not without risks. The main concerns with long-term aspirin use involve gastrointestinal bleeding and hemorrhagic stroke, which is caused by bleeding in the brain.

Gastrointestinal Bleeding

Because Aspirin inhibits COX-1 and reduces the protective prostaglandins in the stomach lining, it can cause irritation and potentially lead to ulcers and bleeding. This risk is higher in individuals with a history of gastrointestinal issues or those taking other medications that also irritate the stomach.

Hemorrhagic Stroke

Although prophylactic aspirin use reduces the risk of ischemic stroke, it can increase the risk of a hemorrhagic stroke due to its blood-thinning properties. This type of stroke occurs less frequently but can be more severe and difficult to treat.

Given these risks, it’s essential that the decision to use Aspirin for cardiovascular disorders and stroke prevention can be made in consultation with a healthcare provider.

Side Effects and Precautions

While aspirin is widely used and generally safe for most people, it can cause side effects, particularly when used long-term or in high doses. Common side effects include:

• Gastrointestinal issues such as stomach pain, heartburn, and ulcers.
• Increased risk of bleeding due to its blood-thinning effects.
• Allergic reactions in some individuals, presenting as hives, swelling, or difficulty breathing.

Aspirin should be used with caution in certain populations, including:

• Children and Teenagers: Aspirin is not recommended for children or teenagers with viral infections due to the risk of Reye’s syndrome, a rare but serious illness.
• Pregnant Women: It is generally advised to avoid aspirin during pregnancy unless prescribed by a healthcare provider, as it can affect both the mother and the developing fetus.
• Individuals with bleeding disorders: Due to its anticoagulant effects, aspirin should be avoided by those with bleeding disorders.

Summary

Aspirin can play a critical role in preventing strokes, particularly ischemic strokes, through its antiplatelet effects. However, its usage should be carefully tailored to each individual’s health profile to balance the benefits of stroke prevention with the potential risks of bleeding and other complications.

Engaging with a healthcare provider is essential to determine the appropriateness of aspirin therapy in the context of stroke prevention, ensuring that the benefits outweigh the potential adverse effects.

In conclusion, aspirin is a versatile medication with a broad range of uses, particularly in pain relief, inflammation reduction, and cardiovascular protection. However, it is important to use it responsibly and under the guidance of a healthcare professional to minimize potential risks and side effects.

Sources:

1. MedlinePlus. Aspirin ↩︎
2. British Heart Foundation. Aspirin and Heart Disease ↩︎
3. American Stroke association. Aspirin and Stroke ↩︎