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Aspirin: is it really a 'wonder drug'?

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It is an effective pain reliever and has been linked to reduced risk of a number of health conditions, including heart attack, stroke and cancer. But is aspirin really the "wonder drug" many health experts claim it is?

Earlier this month, it was announced that researchers from the UK would be embarking on the biggest clinical trial of aspirin to date - the Add-Aspirin phase 3 trial - investigating whether the drug is effective for preventing cancer recurrence through a study of around 11,000 people.

The announcement has caused much excitement in the medical world, with many health experts claiming the trial could be "game-changing" if the drug is found effective, offering a non-expensive strategy to improve survival for cancer patients.

Cancer is just one in a long line of illnesses that aspirin may combat. But in the midst of potential health benefits comes a number of risks, a fact some health professionals believe is often overlooked.

"Because it's been around a long time people think 'it must be safe and it can't do me any harm,'" Prof. Peter Weissberg, medical director of the British Heart Foundation in the UK, told The Independent. "They are taking it 'just in case,' but it's much more dangerous than some other drugs which people get concerned about, like statins."

In this Spotlight, we take a closer look at the potential health benefits of aspirin, as well as the risks associated with the drug.
Aspirin: one of the most commonly used drugs worldwide

Aspirin is a drug that was developed by German research chemist Felix Hoffman, of pharmaceutical company Bayer, in 1897.

Hoffman created aspirin by developing a process to synthesize acetylsalicylic acid (ASA) - a synthetic derivative of a compound called salicin, which is found naturally in plants such as the willow tree.

Early clinical trials of aspirin found it was an effective treatment for pain, fever and inflammation. It is believed the drug produces these effects by inhibiting the production of pain-producing chemicals called prostaglandins. As such, aspirin is commonly used to help ease headache, muscle pain, toothaches and common colds, as well as swelling in arthritis.

More recently, however, researchers have discovered aspirin may also be an effective blood thinner, preventing the formation of blood clots in the arteries by blocking the production of a prostaglandin called thromboxane, which plays a key role in blood clotting.

As such, studies have shown daily aspirin therapy may lower the risk for heart attack and stroke, and it is often recommended for adults at high risk for these conditions.
The possible risks of aspirin use

However, as with any drug, there is a risk for side effects with regular aspirin use.

One of the most severe side effects of regular aspirin use is gastrointestinal bleeding, which can raise the risk of developing a stomach ulcer. If one already has a stomach ulcer, taking aspirin could cause further bleeding and be potentially life-threatening.

Aspirin may also interact with other drugs and increase risk of internal bleeding, particularly drugs with anti-clotting properties, such as warfarin, apixaban and dabigatran. Taking aspirin with some dietary supplements, such as evening primrose oil and fish oil, may also raise internal bleeding risk.

Some individuals are allergic to aspirin, with people who have asthma most at risk. An allergic reaction to the drug may cause swelling of the lips, mouth or throat, breathing problems and a skin rash.

Other side effects of aspirin include headache, nausea and vomiting, tinnitus and bruising.

Some studies have linked aspirin use with increased risk for other health conditions. In 2013, for example, a study published in JAMA Internal Medicine suggested long-term use of the drug may increase the risk of age-related macular degeneration - the primary cause of blindness among older adults.

Previous research has also linked aspirin use to greater risk for Reye's syndrome - a rare disorder characterized by swelling in the brain and liver, most common among children and teenagers.

Despite these potential risks, however, aspirin has become one of the most widely used over-the-counter drugs around the globe; more than 100 million standard aspirin tablets are produced every year.

But people are not just using the drug to relieve the odd headache or cold. It seems aspirin is growing in popularity as more people are taking the drug regularly with the aim of preventing numerous health conditions for which studies have suggested it is effective against.
Aspirin and heart health

As mentioned previously, one of the many benefits of aspirin is believed to be its ability to prevent the formation of blood clots.

Last year, Medical News Today reported on a study by researchers from Australia that found individuals with venous thromboembolism (VTE) - a condition comprised of deep vein thrombosis (blood clots in the legs) and pulmonary embolism (in which a blood clot breaks off and travels to the lungs) - saw a 42% reduction in blood clot recurrence with a 100-mg dose of aspirin daily.

This and numerous other studies hailing the anticoagulant properties of aspirin have led to recommendations that people at high risk for heart attack or stroke may benefit from daily aspirin therapy.

The American Heart Association (AHA), for example, recommend daily low-dose aspirin - under the instruction of a health care provider - for heart attack survivors and others at high risk of heart attack.