An Aspirin a Day?

In the United States, guidelines for who should be taking a low dose of daily aspirin have changed in recent years. As recently as 2009, the American Diabetes Association (ADA) recommended that all adults with diabetes take low-dose aspirin daily as a preventive measure to ward off heart attacks and blood-clot-related strokes. But in 2010, the ADA — along with the American Heart Association and the American College of Cardiology — issued new guidelines that limit the recommendation of daily low-dose aspirin among people with diabetes to men over the age of 50, women over the age of 60, and those of any age who have a major heart risk factor such as as a prior heart attack. In developing the 2010 guidelines, researchers said they saw the need to balance aspirin’s potential benefits against its risks, which may include stomach bleeding and, in some cases, brain bleeding.

A new study, however, finds that daily low-dose aspirin may not even be beneficial in some older adults. Presented last month at the annual meeting of the American Heart Association in Chicago, the study looked at more than 14,000 Japanese between the ages of 60 and 85. According to a HealthDay article on the study, all participants had either high blood pressure, high cholesterol, or diabetes (or some combination of the three). Some of the participants, chosen randomly, were prescribed daily low-dose aspirin. Participants were followed for an average of five years, during which there was no significant difference in the rate of heart attacks, strokes, or death (from any cause) between the two groups.


This study does carry a couple of caveats, however. First, the two groups didn’t see completely identical outcomes. People taking aspirin were more likely to experience gastrointestinal bleeding, while those not taking aspirin were more likely to experience angina (chest pain) or a ministroke. It’s also important to note that there are key differences between the Japanese and American populations. Japanese tend to have fewer heart attacks and more strokes than Americans, particularly hemorrhagic (bleeding) strokes. Since aspirin has been shown in some studies to help prevent heart attacks and blockage-related strokes, it may be the case that a significant benefit would be seen in an identical study using American participants.

Yet there are still unanswered questions about the effects of aspirin in the American population, particularly in people with diabetes. One study released in 2012 found that in a group of almost 200,000 people, those taking low-dose aspirin were much more likely to experience major gastrointestinal or brain bleeding — in fact, this risk was about as strong as the heart-protective benefits seen from taking aspirin. Yet among people with diabetes, who already had a higher risk of bleeding than the general population, aspirin did not appear to increase this risk. According to the researchers, this result means that the benefits of low-dose aspirin among people with diabetes might also be called into question by further studies.

Do you take low-dose aspirin daily? If so, what reasons did your health-care provider discuss with you in reaching this decision? Have you ever experienced a heart attack or stroke, or bleeding that might be attributed to aspirin? Are you confident in the current recommendations regarding who should take aspirin and who shouldn’t? Leave a comment below! (And remember: Never stop taking aspirin without medical supervision, as doing so abruptly may cause a dangerous blood clot.)