Aspirin - Preventing Heart Attacks and Strokes
Aspirin taken at low dose lowers the chance of having a heart attack or stroke for people with 'artery conditions'. People who may benefit include those with the following: angina, previous heart attacks, heart by-pass surgery, peripheral vascular disease, previous strokes or transient ischaemic attacks ('mini strokes'). One in four heart attacks and strokes may be prevented by taking aspirin. This may be up to 7000 each year in the UK.
How does aspirin work?
In some people, usually older people, some blood vessels (arteries) become 'furred up' with fatty lumps. This is often known as 'hardening of the arteries'. The fatty lumps are called atheroma, which takes many years to develop. Platelets are tiny particles in the blood that help the blood to clot when skin or a blood vessel is cut. If large numbers of platelets become stuck onto atheroma (fatty lumps) inside an artery they form a clot (a thrombosis). This clot then stops blood flowing in an artery and the tissues downstream lose their blood supply. This can be anywhere in the body but commonly it affects blood vessels in the heart and brain. This is the common cause of heart attacks and strokes. Low dose aspirin has an effect of reducing the 'stickiness' of platelets. This reduces the chance of clots forming.
Are there any side effects from aspirin?
In most people there are no side effects as the dose is small. However, aspirin in some people causes stomach pains or indigestion. Rarely it can cause bleeding of the stomach or duodenum (upper intestine). This is more common in people who have stomach or duodenal ulcers. Any persistent stomach pain, blood in vomit or black motions (faeces) whilst taking aspirin should be reported quickly to a doctor. Rarely, some people are allergic to aspirin. Aspirin sometimes makes breathing symptoms worse in people who have asthma.
Who should not take aspirin?
It is not recommended for everyone. In those with atheroma conditions listed above the benefits far outweigh the small risks of side effects with low dose aspirin. No benefit has been shown for people who do not have the atheroma conditions.
What is the dose of aspirin?
A low dose works best (75mg) Should you need to take painkillers (for example, for headaches) it is best to take alternative painkillers such as paracetamol.
Conclusion
Aspirin is an important part of the treatment for atheroma conditions. However, it is no substitute for preventing the development of atheroma. Well known risk factors should still be seriously addressed. For example, any smoking should stop, exercise should be encouraged, the diet should be low in fats and high blood pressure should be controlled.
If you have further questions, please ask us during your next visit to the Doctor.