Follow our next article to know more with aspirin

What is aspirin? And how does it work?

• Aspirin is a salicylate and is also known as acetylsalicylic acid. It  belongs to the class of medicines known as nonsteroidal anti inflammatory drugs (NSAID), and may also be grouped with the nonopioid analgesics and antiplatelet agents.
• Aspirin blocks the effects of cyclooxygenase-1 (COX-1) and COX-2 enzymes which prevents the synthesis of prostaglandins, which are hormone-like substances that modulate inflammation and are also involved in smooth muscle contraction and relaxation, blood vessel narrowing and widening and blood pressure control , and it affects platelets because it inhibits the formation of thromboxane A2, a prostaglandin derivative. This reduces the ability of the blood to clot.

Is taking aspirin preventively harmful to health?

• For decades, a daily dose of aspirin was considered an easy way to prevent a heart attack, stroke or other cardiovascular event.

• Then came a string of recent studies challenging that assumption. With this latest research in mind, a new set of guidelines to help people stay heart-healthy is advising against daily aspirin use for prevention. It may actually cause more harm than good.

• “We’re talking about healthy people who don’t have known heart disease or stroke, who might have been considering or already taking an aspirin to prevent that heart attack or stroke in the first place,” said Dr. Erin Michos, one of the writers of new prevention guidelines developed by the American Heart Association and American College of Cardiology.

• The new recommendation doesn’t apply to people who already have had a stroke or heart attack, or who have undergone bypass surgery or a procedure to insert a stent in their coronary arteries.

• These individuals already have cardiovascular disease and should continue to take low-dose aspirin daily.

• According to many significant studies , the benefit from taking a daily low-dose aspirin was offset by the danger of internal bleeding and other side effects in people considered to be at low or moderate risk for heart disease.

• One study in particular found aspirin had no obvious benefit for healthy people older than 70 but found evidence for harm, which is why the new prevention guidelines strongly discourage aspirin as a protective therapy among these older adults.

• The U.S. Preventive Services Task Force, an independent panel of national experts in disease prevention, recommends a low-dose aspirin regimen for adults 50 to 59 whose 10-year risk of developing cardiovascular disease is more than 10 percent.

• But today, the benefit for taking aspirin for the majority of otherwise healthy adults just doesn’t outweigh the risks enough. Aspirin still may be considered for very select high-risk adults ages 40-70 who are not at increased risk for bleeding, if advised by their doctors.

• “For primary prevention, the risk of bleeding and the benefits of reducing heart attack are pretty matched, even to even. So there isn’t a lot of gain for taking aspirin,” Michos said. Primary prevention is a term for avoiding a first heart attack, stroke or other type of cardiovascular event.

• “It’s clear that for certain populations – the elderly and, in particular, patients who have a high (internal) bleeding risk – aspirin may in fact do more harm than good, but there are no absolutes, so these decisions need to be tailored to the individuals.”

• But for most people considered to be at low or moderate risk, they can better protect themselves with healthier habits, Michos said.

• “Eat a heart-healthy diet, get regular physical activity, control blood pressure and control cholesterol,” she said. “If they need the statin, take it. Those are much more important when compared to recommending aspirin.”

Aspirin Tips

1. For most heart conditions, the typical maintenance dose is 81 mg once daily.
2. Dosages given for pain relief are generally higher than those given for heart conditions.
3. Do not give aspirin to children or teenagers with flu symptoms, fever, chickenpox, or any suspected viral illness due to the possibility of Reye’s syndrome (a rare but serious condition that causes swelling of the brain and liver).
4. Small amounts of antacids taken with aspirin may decrease stomach irritation.
5. Treatment with aspirin may need to be stopped a couple of weeks before surgery; check with your doctor..

 Interactions

Medicines that interact with it may either decrease its effect, affect how long it works for, increase side effects, or have less of an effect when taken with it. An interaction between two medications does not always mean that you must stop taking one of the medications; however, sometimes it does. Speak to your doctor about how drug interactions should be managed.

Common medications that may interact with it include:

• ACE inhibitors such as benazepril, captopril, and enalapril
• acetazolamide
• anticonvulsants such as phenytoin or valproic acid
• apixaban
• beta-blockers such as atenolol, labetalol, or metoprolol
• corticosteroids, such as prednisone and methylprednisone
• digoxin
• furosemide or other diuretics
• medications for gout, such as probenecid
• methotrexate
• mifepristone
• NSAIDs, such as ibuprofen, diclofenac, etodolac, and naproxen
• tetracyclines, such as doxycycline and minocycline
• warfarin.

References:

• https://www.heart.org/en/news/2019/03/18/avoid-daily-aspirin-unless-your-doctor-prescribes-it-new-guidelines-advise
• https://www.drugs.com/tips/aspirin-patient-tips