Do not take Aspirin to prevent heart attack.
At least that is what the science shows and what I have been telling people at my talks.
Aspirin or acetylsalicylic acid (ASA) has been used for decades to reduce the risk of heart attacks. Unfortunately, someone forgot to tell the doctors that the benefit is minimal and the side effects can be serious.
Most recently 3 large random controlled trials of moderate-risk, elderly, and diabetic patients do not support the use of ASA for primary prevention. The potential absolute benefit of about 1% is offset by a similar increase in major bleeding and many other minor side effects.
All-cause and cancer mortality were either unchanged or increased with Asprin. In one trial after 5 years, there was no difference in the number of cardiovascular events (4.3% vs 4.5% for placebo) or the mortality rate but major gastrointestinal bleeds increased from 0.1% to 0.3%.
A second study after 7.4 years the number of CV events was 8.5% compared to 9.6% for placebo but the number of increased fatal or major bleeding went from 3.2 to 4.1%.
The third study after 4.7 years (which was stopped early),the patients had no difference in cardio vascular events (3.5% vs 3.9% for placebo). But there was an increase in fatal bleeds from 2.8% to.8% and all-cause mortality from 5.2% for placebo to 5.9%, and cancer deaths from 2.3% to 3.1% for the Aspirin group. Taken together these three large studies say there is no benefit and there is the risk of serious harm.
Note none of the studies looked at all the other gut related illnesses that are also linked to Aspirin that can lead to a serious lowering of the quality of life.
Bottom line. Make sure you tell your health professional because they probably will not know this.
Paul Fritsch and Michael R. Kolber
Canadian Family Physician July 2019, 65 (7) 480;