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What Are The Risks Of Daily Aspirin Therapy?
Question: I am curious about the benefits and risks of daily aspirin therapy. I am a 36 yr old male with elevated cholesterol, some family background of heart issues and autoimmune diseases but otherwise healthy. I have also been diagnosed with LPR by and ENT and PPI's are not effective for me as the condition comes and goes. There seems to be a lot of recent data regarding cancer prevention with long term low dose aspirin therapy, particularly cancer's of the colon and esophagus. The risk factors of daily low dose aspirin therapy seems to be mainly in older adults and include GI bleeding and hemorrhagic stroke in a small number of people. The potential benefits of a lower risk factor of 30-60 percent of many cancers seem to outweigh the potential risks in someone younger. Adding to further confusion is that the medical community seems to be split on this issue with some doctors saying the benefits far outweigh risks in most people and other doctors saying that the potential complications are worse than any derived benefit. I'm looking for your opinion and some clarity on the issue. Thank you.
Brief Answer:
Individualized approach -weigh benefit vs risk
Detailed Answer:
Hello,
Thank you for asking this query on HCM.
I congratulate you for being interested in disease prevention and for the reading up done. As you have very rightly stated the use of aspirin for all is controversial What follows is my opinion and what I carry out in my practice.
You must be well aware of its benefit in preventing cardiovascular events and I do not want to waste our time dealing with that. The benefit in preventing gastrointestinal malignancies have a latent period of over 5 years and probably 10 years. So it is not advisable to start aspirin after the age of 70 years. The risk of GI bleed outweighs any potential benefit of cancer prevention. In a younger person with a family history of GI malignancies like colon, gastric or esophageal, I would advise low dose aspirin of 75 mg per day if he/she can tolerate it. As you might know the data suggests that 75 mg may be as useful as the 300 mg , though to my knowledge there is no head to head study.
The same goes for a person with several risk factors for cardiovascular disease.
So the approach for use of aspirin has to be individualized and there is no shoe that fits all.
I shall be happy to answer if you have any further query.
Wish you good health
Dr. Noble Zachariah, Kuwait
Individualized approach -weigh benefit vs risk
Detailed Answer:
Hello,
Thank you for asking this query on HCM.
I congratulate you for being interested in disease prevention and for the reading up done. As you have very rightly stated the use of aspirin for all is controversial What follows is my opinion and what I carry out in my practice.
You must be well aware of its benefit in preventing cardiovascular events and I do not want to waste our time dealing with that. The benefit in preventing gastrointestinal malignancies have a latent period of over 5 years and probably 10 years. So it is not advisable to start aspirin after the age of 70 years. The risk of GI bleed outweighs any potential benefit of cancer prevention. In a younger person with a family history of GI malignancies like colon, gastric or esophageal, I would advise low dose aspirin of 75 mg per day if he/she can tolerate it. As you might know the data suggests that 75 mg may be as useful as the 300 mg , though to my knowledge there is no head to head study.
The same goes for a person with several risk factors for cardiovascular disease.
So the approach for use of aspirin has to be individualized and there is no shoe that fits all.
I shall be happy to answer if you have any further query.
Wish you good health
Dr. Noble Zachariah, Kuwait
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Above answer was peer-reviewed by :
Dr. Shanthi.E
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