Daily Aspirin? Probably not worth aspiring to

If you’re one of the millions and millions out there who’ve been convinced – by ubiquitous ads, of course, or by multiple media headlines, or your family doc, or perhaps even by some talking head doc on TV – to take daily ASA (Aspirin in the US) because it will undoubtedly help you live longer by lowering your risk of a “cardiovascular event” (medicalese for a heart attack, stroke, or sudden death from one of those), then this latest study published in JAMA might make you think otherwise.

At least it should.

In this meta-analysis, the researchers reviewed 113 previous studies on the effects of taking daily low-dose ASA in people who have not had a previous heart attack of ischemic stroke and their conclusions will surprise many of you, I’m sure.

In order to reduce the risk of a first heart attack or stroke, 250 people have to take an ASA every day for 5 years in order to reduce the risk of one heart attack among them – repeat, 250 people taking an ASA every day for 5 years, one less heart attack in total.

However, among 210 people taking daily ASA for 5 years, there will be one potentially life-threatening serious bleed either in the brain as a hemorrhagic stroke or in the gut from an ulcer – repeat, one in 210 people taking daily ASA for 5 years will suffer a serious, life-threatening bleed as a consequence.

So the risk of bleeding is slightly greater than the lowered risk of heart attack or first stroke.

Which is why, most studies show that people taking daily ASA do not live any longer than the people who don’t.

So, as Harry Callahan might put it: Do you feel lucky (for 5 years?)

Will you be the one in 250 to get the benefit of daily ASA use?

Or might you be the one of the 210 unlucky ones?