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The Dark Side of Your Daily Aspirin Habit

It might help your heart health, but it also might leave you riddled with ulcers and internal bleeding

What’s America’s favorite drug to do everyday? Coke? Weed? Shrooms

Nope. Looking at the numbers, you could make a convincing argument that good ol’ aspirin takes that honor. 

A study released last week found that almost 30 million Americans older than 40 take aspirin daily to prevent cardiovascular disease, and more than 6 million of them are doing so without a physician’s recommendation. The use curves upward with age; nearly half of Americans older than 70 without cardiovascular disease gulp down a little white pill each day, according to the survey. 

Here’s the twist: Major medical organizations are no longer recommending the average person take aspirin daily as a preventative drug. In fact, multiple studies in 2018 found it had little to no positive impact. And researchers now note that healthy people without a previous heart attack or stroke could have problems with bleeding, stomach ulcers and other side effects if they continue a daily aspirin regimen. “In a relatively healthy group of 95,000 volunteers, the reduction in heart attacks and strokes in people taking aspirin was almost counterbalanced by major bleeding in the gastrointestinal system and the brain. The researchers concluded that for individuals without previously diagnosed cardiovascular disease, ‘aspirin is of uncertain net value,’” Harvard Medical School has reported on these findings

The full-strength stuff is used to treat everything from fever to muscle soreness, comparable to ibuprofen, naproxen (Advil) and other anti-inflammatory painkillers you can find at the corner store. But for decades, popular belief has suggested that low-dose aspirin can also help prevent heart-related illnesses and stroke without any complicated side effects. 

The pharmaceutical company Bayer originally trademarked aspirin at the turn of the 20th century and grew to become the leading producer of the drug. The benefits of aspirin as a painkiller were obvious then, but it was only in 1960s and 1970s that research began to show the drug’s impact on the clotting properties of blood. Heart attacks and strokes happen when blood stops moving in a narrow blood vessel, and aspirin appeared to thin out blood in a way that safely reduced the odds of cardiovascular emergencies. 

By the mid-1980s, the continuation of sophisticated research helped cement aspirin’s usefulness as a preventative medicine. The Sterling Drug Company, which distributed Bayer aspirin, lobbied regulators so it could claim that aspirin had benefits in stopping a second heart attack. It got the green light in 1985. Bayer’s invigorated marketing assault came shortly after, with a sparkling new slogan: “Wonder Drug That Works Wonders.” It was perfect timing, given that aspirin sales had begun to drag in the 1980s with increased consumer use of ibuprofen and acetaminophen. 

For the next three decades, dads and doctors everywhere seemed to agree: Baby aspirin was a harmless pill that could stave off a life-changing medical emergency. No wonder the new guidelines have surprised a lot of medical professions. The new data serve as “the ugly facts which slay a beautiful theory,” as John McNeil, of the department of epidemiology and preventive medicine at Monash University in Australia, told the New York Times

So what do you do now? Talk to your doctor, for one, especially if you have a history of cardiovascular health problems and feel like aspirin could continue to help. After all, it’s still true that an aspirin regimen is effective at stopping a second heart attack. For the average person, though, the new guidelines suggest behavioral changes to strengthen the heart instead. “These include maintaining a healthy weight, not smoking, engaging in moderate activity for at least 150 minutes a week and a diet that includes vegetables, fruits, nuts, whole grains and fish,” concludes the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines.

In other words, stuff that’s a lot tougher to do consistently than just pop some tiny pills each day. Talk about hard to swallow.