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Low Dosage Aspirin: Does Taking One Daily Help Anything?

Since someone, either in my office or by e-mail, asks me this question at least once a week, this might be a good opportunity to put the matter to rest.

Or maybe not.

Physicians, especially cardiologists, have been recommending daily aspirin to their patients for decades. The theory rested on the phenomenon that aspirin ever so slightly interfered with blood clot formation, and that small blood clots were responsible for heart attacks and strokes. You didn’t need to take much: a low-dose aspirin (81 mg–formerly called baby aspirin) would do just fine.

But then some studies started to appear that concluded the daily aspirin idea was pretty lame. When data from five very large studies was published, comparing aspirin users with non-users, nothing dramatic emerged and the general recommendation from doctors shifted to “Take it if you want to. It might help, might not.”

However, an article in the March 26, 2007, Archives of Internal Medicine might blow all the previous studies out of the water. The Nurses’ Health Study has been tracking almost 80,000 women since 1980 on a variety of health and lifestyle issues. Now, 27 years later, the statisticians reported some very explicit results.

If women take low-dose or moderate-dose aspirin (ranging from a daily 81-mg aspirin up to as high as 14 tablets per week), there is a significantly lower risk of death from all cause mortality, particularly among older women and those with risk factors for heart disease. Also, starting aspirin when you’re young enhances the benefits, especially the cancer prevention ones.

“All cause mortality” is just what it sounds like. Aspirin users have fewer fatal heart attacks, fewer strokes, and fewer of the three commonest cancers (heart, lung, and colon).

Will this report end the argument? No. The authors of the previous papers will find flaws in this study and will likely be arguing about it for decades.

I find this report compelling. The risk-reward ratio, asking “how safe?” versus “what’s the benefit?” leans very heavily in favor of one low-dose aspirin daily.

So that’s my answer.

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