Aspirin has been around for about 120 years. It is a common remedy for aches, pain and headaches. For years many doctors have recommended daily aspirin therapy for healthy adults as a way to help reduce the risk of heart attacks and other cardiovascular issues.
More recent studies show that this type of therapy has its own health risks such as excessive bleeding, (2) Crohn’s disease, gastric ulcer, hearing loss, Reye syndrome and H. pylori infection. But before we go too far, let’s step back and look at aspirin therapy.
What is Daily Aspirin Therapy?
If you are one of the millions who take aspirin daily, it’s important to know that in 2014 the FDA reversed its position on daily aspirin therapy. Their stance is that healthy individuals shouldn’t be taking daily aspirin even with a family history of heart disease. (1, 2)
Daily aspirin therapy has been considered a preventative measure for individuals at risk for cardiovascular events. (3) Daily aspirin therapy can be suggested for conditions such as:
- Previous heart attack or stroke.
- High risk of heart attack or stroke.
- You’ve had coronary bypass surgery.
- You have diabetes or other heart risk factors such as high blood pressure or are a smoker.
Aspirin Side Effects
As with any medication, there are potential side effects, including (3):
- Allergic reaction- If you are allergic to aspirin you need another option.
- Gastrointestinal bleeding- Taking aspirin daily can increase your risk of stomach ulcers. If you already have an ulcer, taking aspirin can cause it to bleed more, even to a life-threatening point.
- Stroke- While many people take aspirin to prevent stroke, it can also increase the risk of hemorrhagic stroke.
How effective is Aspirin Therapy?
According to a very large scale clinical study in Australia, aspirin therapy has no effect on prolonging life in elderly patients. In fact, the study showed participants age 70 and older were at greater risk of hemorrhages.
Furthermore, The American College of Cardiology and the American Heart Association updated their guidelines in March, which reversed the recommendation of a low-dose, daily aspirin to prevent heart attacks and strokes for individuals who don’t have a history of cardiovascular disease.
The findings were based on a 2017 NHIS. (National Health Interview Survey) The analysis of the survey was published in July 2019 in the Annals of Internal Medicine, Harvard Medical School, Boston. The survey questioned individuals regarding their intake of low dose aspirin, without defining what exactly that meant. (4, 5)
Due to the additional findings of three studies, in March of 2019 The American College of Cardiology has published new guidelines with a recommendation against routinely giving aspirin to older adults who don’t have a history of heart disease.
The three trials ARRIVE, ASPREE and ASCEND had the following results:
ARRIVE– Daily dose of 100 mg. was not shown to reduce stroke and long term risk of cardiovascular events.
ASPREE-This trial showed an increase in all mortality and no change in cardiovascular mortality. In fact it showed a significantly higher risk for major hemorrhage.
ASCEND-While this study showed a 12% reduced the risk of vascular events, it also showed a 29% increased risk for major bleeding. (6, 7, 8, 9)
Considerations for Aspirin Therapy
Before taking aspirin (especially low, long term doses), you should discuss this therapy and any other options with your doctor to determine the best protocol for you.
Those at highest risk for complications are individuals over 70 and those with gastric ulcers.
If your doctor recommends this therapy, for an existing condition you should continue this protocol. If you are uncomfortable with this treatment, you should discuss other options with your doctor.
Natural Alternatives to Aspirin
There are numerous natural options for aspirin that offer comparable results for cardiovascular protection. These options work by reducing the ability of platelets to aggregate or clump together. The greatest benefits of these natural options is avoiding the risk associated with long term, low dose, daily aspirin.
Pycnogenol is an extract of French pine bark with anti-inflammatory and antioxidative effects. Individuals in the study taking doses of 200 mg showed significantly reduced platelet aggregation. (10)
Omega 3 Fish Oil is a great option for healthy individuals to reduce platelet aggregation, this study showed greater reductions with healthy participants, while those with CVD did not see as significant reduction. (11)
Policosanol is a wax extract made from sugar cane. It is known for the ability to reduce cholesterol and it also inhibits platelet aggregation. (12)
Turmeric and Curcumin–Curcumin is the primary component of turmeric and prevents platelet aggregation and offers anti-inflammatory benefits as well. (13)
Natural Steps to Improving Cardiovascular Health
Avoid inflammatory foods-For many people the cause of heart disease may be inflammation. Consider avoiding foods that promote inflammation such as nightshades, corn and soybeans, sugar, trans fats, conventional meats and dairy. (14)
Make healthy lifestyle changes-While genetics can actually double the risk of heart disease, a healthy lifestyle can cut those numbers in half. Consider quitting smoking, eating whole organic foods and exercise. (15)
Heart healthy supplements-Your best option is always a healthy organic diet. You may however consider supplements which help to reduce inflammation and support a healthy heart; Omega 3 fish oil, Curcumin, Vitamin C, D, E*, Selenium, and COQ10. Consult with your healthcare practitioner before starting any new supplements to see if they are right for you.
*When considering vitamin E in supplemental form, look for one containing a full spectrum of the 8 E-complex vitamers.
While aspirin therapy may benefit to some, it is not a benefit to everyone. Your complete medical history must be considered before this protocol.
As Susan Smyth, MD, PhD shared with theheart.org | Medscape Cardiology; “As physicians, we are reasonably good at implementing guideline-directed medical therapy when we know something works. What we don’t do a very good job at is de-implementing when we learn that it maybe doesn’t work so well. De-implementation is much harder,” she said. (16)
It is always important to speak with your doctor before starting or stopping a medication, even over the counter medication such as aspirin.
The primary focus is always to make healthy lifestyle changes such as eating whole organic foods, quitting smoking and adding an exercise regimen. If need be, consider adding some heart healthy supplements.
Disclaimer: This information is not intended to be a substitute for professional medical advice, diagnosis or treatment and is for information only. Always seek the advice of your physician or another qualified health provider with any questions about your medical condition and/or current medication. Do not disregard professional medical advice or delay seeking advice or treatment because of something you have read here.
- 2014, May 5). Can an Aspirin a Day Help Prevent a Heart Attack? Retrieved from https://www.fda.gov/consumers/consumer-updates/can-aspirin-day-help-prevent-heart-attack
- Time to rethink daily aspirin therapy. Retrieved from https://blogs.mercola.com/sites/vitalvotes/archive/2019/08/06/time-to-rethink-daily-aspirin-therapy.aspx
- (2019, January 9). Should you take a daily aspirin for your heart? Retrieved from https://www.mayoclinic.org/diseases-conditions/heart-disease/in-depth/daily-aspirin-therapy/art-20046797
- NHIS – National Health Interview Survey Homepage. Retrieved from https://www.cdc.gov/nchs/nhis/index.htm
- O’Brien, C. W., Juraschek, S. P., & Wee, C. C. (2019, July 23). Prevalence of Aspirin Use for Primary Prevention of Cardiovascular Disease in the United States: Results From the 2017 National Health Interview Survey. Retrieved from https://annals.org/aim/article-abstract/2738925/prevalence-aspirin-use-primary-prevention-cardiovascular-disease-united-states-results
- (2018, August 26). Daily Aspirin Fails as Primary Prevention in ARRIVE Trial. Retrieved from https://www.medscape.com/viewarticle/901208
- (2018, September 16). ASPREE: No Benefit of Aspirin in Primary Prevention. Retrieved from https://www.medscape.com/viewarticle/902056
- Effect of Aspirin on Cardiovascular Events and Bleeding in the Healthy Elderly: NEJM. Retrieved from https://www.nejm.org/doi/full/10.1056/NEJMoa1805819?query=featured_home
- (2018, August 27). ASCEND: Aspirin Not Needed for Primary Prevention in Diabetes. Retrieved from https://www.medscape.com/viewarticle/901212
- Pütter, M., Grotemeyer, K. H., Würthwein, G., Araghi-Niknam, M., Watson, R. R., Hosseini, S., & Rohdewald, P. (1999, August 15). Inhibition of smoking-induced platelet aggregation by aspirin and pycnogenol. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/10498385
- McEwen, B. J., Morel-Kopp, M.-C., Chen, W., Tofler, G. H., & Ward, C. M. (2013, February). Effects of omega-3 polyunsaturated fatty acids on platelet function in healthy subjects and subjects with cardiovascular disease. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/23329646
- Arruzazabala, M. L., Valdés, S., Más, R., Carbajal, D., & Fernández, L. (1997, October). Comparative study of policosanol, aspirin and the combination therapy policosanol-aspirin on platelet aggregation in healthy volunteers. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/9425618
- Srivastava, K. C., Bordia, A., & Verma, S. K. (1995, April). Curcumin, a major component of food spice turmeric (Curcuma longa) inhibits aggregation and alters eicosanoid metabolism in human blood platelets. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/7784468
- C-Reactive Protein, a Sensitive Marker of Inflammation, Predicts Future Risk of Coronary Heart Disease in Initially Healthy Middle-Aged Men. Retrieved from https://www.ahajournals.org/doi/full/10.1161/01.CIR.99.2.237
- Genetic Risk, Adherence to a Healthy Lifestyle, and Coronary Disease: NEJM. Retrieved from https://www.nejm.org/doi/full/10.1056/NEJMoa1605086
- (2019, July 25). Millions on Daily Aspirin for CV Prevention, Probably Shouldn’t. Retrieved from https://www.medscape.com/viewarticle/916048
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