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Say 'Aaah' | The Healthy Man

Use Caution With Daily Aspirin Use

November 09, 1998|KRISTL J. BULURAN | Kristl Buluran has a graduate degree from the UCLA School of Public Health and is a laboratory researcher in Los Angeles

Many men in their 50s and older are taking aspirin on a daily basis as a prophylactic for a heart attack or stroke. My father was one of those men, deemed at high risk because of his age, diet, weight and family history of stroke and hypertension. He was taking an aspirin a day hoping to prevent a heart attack or stroke. However, like many men on aspirin therapy, my father was largely unaware of aspirin's potential side effects.

Aspirin, also known as a nonsteroidal anti-inflammatory drug, inhibits the production and release of proteins called prostaglandins that cause pain while also helping to bring fever down. Its recent use in preventing a heart attack or stroke is due to the fact that aspirin also helps thin the blood by reducing the clumping of platelets, a cellular component of blood that forms a sticky plug to seal the opening of a blood vessel when a person is injured and bleeding.

Some studies have shown that regular aspirin use helps prevent a heart attack or ischemic stroke, in which a clot forms in an artery leading to the brain and prevents oxygenated blood from reaching brain tissue, causing the brain to "suffocate." The American Heart Assn. recommends an aspirin a day if you have had a previous heart attack or if you are at high risk for a heart attack or ischemic stroke.

Also, men are generally at higher risk for heart attack or stroke than women, although there is evidence that after 55, the risk for both is fairly equal.

What many men do not realize is that there is some risk to regular aspirin use. There is an increased risk of gastrointestinal problems with chronic use, especially in men with history of ulcers.

Furthermore, chronic use can also contribute to excessive bleeding as well as an increased risk for a hemorrhagic stroke, in which a blood vessel in the brain ruptures or leaks, depriving other parts of the brain from receiving oxygenated blood while damaging the surrounding brain tissue as blood spills into the area around the rupture. For those on aspirin therapy, the effects on this type of stroke can be devastating, since the blood has thinned and excessive bleeding is imminent.

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My father died of a hemorrhagic stroke at 55. He had been on aspirin therapy for several years, recommended by his primary care physician, but for the most part, self-prescribed. It is quite possible that my father was at an increased risk for this type of stroke because of lifestyle and family history, but I believe that it is also quite possible aspirin contributed to the stroke being fatal.

If you are among the men who are on self-prescribed aspirin therapy or are thinking about it, I recommend you take a good look at the problems that need addressing. Many studies have shown that aspirin has its benefits in helping to prevent a heart attack or stroke.

However, there is no magic bullet to preventing the consequences of a diet high in fat and cholesterol, lack of exercise, smoking and excessive drinking; these require conscious changes in behavior and lifestyle. Most importantly, I recommend you consult with your doctor before taking aspirin, or any other drug for that matter. Aspirin treatment is highly individualized.

You may have risk factors that aspirin may complicate, and only your doctor, armed with a complete medical history, can identify these. Finally, do not take more than the recommended dose of aspirin for use as a prophylactic. Most doctors suggest one baby aspirin (81 milligrams), or for high-risk cases, one adult aspirin (325 milligrams). Higher doses may increase your risk for the more serious side effects of aspirin.

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