If you’re one of the millions and millions of people who’ve decided to take ASA every day to prevent a heart attack even though you’re not at a huge increased risk of suffering one, a new huge study from Italy published in the Journal of the American Medical Association might make you think twice about your decision because there is a huge downside to taking ASA regularly (which most people rarely consider when they pick up some over-the-counter ASA), and for most people at average risk of heart attack (which is the great majority of us), this study has concluded that downside pretty much balances out the potential gains.
More specifically, this study concludes that while taking a low-dose ASA every day will reduce the overall risk of heart attack by about 2 per 1000 users, it also increases the risk of severe and sudden bleeding by roughly the same amount.
And severe sudden bleeding with ASA carries a significant potential risk of sudden death, too, not only from bleeding from the gastrointestinal tract, but also from bleeding into the brain, what’s known as a hemorrhagic stroke, which carries a pretty grim prognosis.
As usual, there are several problems with this study, of course, starting with the fact that the researchers here defined “low dose” as anything under 300 mg/day, and most Canadians who use ASA use a lower dose than that, plus the fact that the researchers could not account for other factors that may have also contributed to a higher risk of bleeding in the ASA users such as the use of other drugs in the ASA family.
That said, it’s a very good study and pretty much backs up what lots of others have found, albeit with an overall risk of bleeding that was higher in these Italians than in other groups that have been looked at.
Bottom line: if you’re at pretty high risk of suffering a heart attack in the near future (a window of 5-10 years), most studies show a significant overall benefit to taking ASA regularly.
If, however, you’re taking an ASA every day because you’ve been suckered in by the advertising or you just think, “What the hell, there’s really nothing to lose”, well, you might want to think again.
Best thing to do is to sit down with your family doc, talk about your risks (there are terrific charts that can tell you what risks you run for a heart attack over the next 10 years), and then decide if ASA is really for you.
It might be.
And it might not.
