Doctor warns heart patients of frequent aspirin use
New Delhi: While there is a raging debate on the role of aspirin in preventing heart attacks, a leading cardiologist has cautioned against people starting the pill therapy on their own.
"The best way to know if you are a candidate for aspirin therapy is to ask your doctor. You should not start aspirin on your own," says Prof Upendra Kaul, Executive Director and Dean, Fortis Escorts Heart Institute and Research Centre.
Earlier studies had established aspirin`s efficacy as an anti-clotting agent leading to its widespread use as a preventive treatment for heart attacks.
However, recent studies showed that aspirin users were about 30 per cent more likely to have a serious gastrointestinal bleeding event, a side-effect of frequent aspirin use.
Though some previous studies suggested that regular aspirin use could prevent cancer, the new analysis showed no such benefit.
"You should not start aspirin therapy without first consulting your physician. The risks and benefits of aspirin therapy vary from person to person," says Kaul.
Although taking an occasional aspirin or two was safe for most adults as a treatment for headaches, body aches or fever, daily use of aspirin can have serious side effects, including internal bleeding, he says.
Taking aspirin is not advised during a brain stroke, because not all strokes are caused by blood clots.
"Most strokes are caused by clots, but some are caused by ruptured vessels. Taking aspirin could potentially make these bleeding strokes more severe," Kaul says.
At present, aspirin is recommended for preventing a heart attack when a person already has had a heart attack or stroke.
The tablet is also prescribed to a person who has not suffered a heart attack, but has a stent placed in a coronary artery, has had a coronary bypass surgery, or has chest pain due to coronary artery disease.
Aspirin is also prescribed to a man with diabetes older than 50 years or a woman with diabetes older than 60 years.
Although aspirin has been recommended in the past for certain groups of people without a history of heart attack or angina, there was disagreement among doctors about this approach, he says.
"Guidelines have changed and aspirin is no longer recommended for primary prevention except in diabetics. This is because the benefit conferred by aspirin can be nullified by the inherent bleeding risk," Kaul says.
He points out that taking aspirin helps during a heart attack as it improves the chances of survival by at least 20 per cent.
"In fact, people having a heart attack are often given an aspirin by emergency medical services. This may take place in the ambulance or in a hospital emergency room," says Kaul.
Earlier this year a study covering more than one lakh participants concluded that healthy people who take aspirin to prevent a heart attack or stroke could be doing more harm than good.
The UK-led study published in Archives of Internal Medicine concluded the risk of internal bleeding was too high.
Only people with conditions such as past heart problems or stroke should take the tablets, the researchers said and advised that any decision on using the tablet should be made after consulting a doctor.