Benefits with aspirin tablet use
Aspirin reduces the risk of heart attack and paralysis stroke in adults. Aspirin possibly reduces the risk of colon cancer.
Aspirin tablet adverse effects/side effects
Unfortunately, it increases the risk of major bleeding. It increases the risk of ulcers in the stomach and the intestine. People on aspirin may develop minor to severe bleeding from the digestive system. It also produces dyspepsia, indigestion, and bloating sensation of the abdomen.
Who are the candidates for primary prevention with aspirin?
Aspirin use has some benefits and harms. Both factors need to be considered before starting aspirin as primary prevention. Primary prevention means preventive measures for heart attack/paralysis stroke in an individual without prior heart diseases and brain stroke.
We should individualize the decision to start aspirin based on the relative risk-benefit ratio. The doctor should compare
the risk of heart attack/paralysis stroke with the risk of major bleeding. In some adults, the benefits may exceed the harms, while in others the harms may exceed the benefits.
Unfortunately for most adults (up to 95% cases), the benefits and harms are likely to be closely balanced. As a consequence, for most adults, we can’t recommend for or against aspirin use. Most adults from the general population fall into the low-risk category for heart attacks, the absolute benefits of daily aspirin are insufficient. They should not take aspirin as prophylaxis.
Ultimately, the decision should be shared decision between doctor and patient after a thorough discussion about the benefits and the harms. Adults not averse to using a medication, more worried about heart attack, less concerned about the bleeding will be inclined to use aspirin; those with the opposite perspectives will be disinclined. Given the absence of net clinical benefits for most adults, aspirin use for primary prevention falls short of the hype.
For adults aged more than 70 years, the harms may overweigh the benefits for primary prevention. they are more prone to bleeding in virtue of their age. They should not be advised for aspirin use for primary prevention. similarly, for adults aged below 40 years, the benefit is insufficient and should not be advised aspirin use.
Even adults with high blood pressure and /or diabetes should not be advised aspirin use for primary prevention according to most experts.
Then, what is the way to prevent a heart attack?
Following general preventive measures like a healthy diet, regular exercise, smoking cessation, keeping blood pressure, sugar and cholesterol under control is the best primary prevention.