Can there be any drug more reassuring than the humble aspirin? Languishing in the bottom of your handbag just waiting for a migraine or hangover to strike, it offers the ultimate quick fix for a host of minor ailments. And then there’s cardiovascular disease. Even if you don’t believe yourself to be at risk, you probably felt comforted that aspirin helped to prevent heart attacks and also strokes. Alas, not quite. New research from Edinburgh University reveals that healthy people who take the painkiller every day almost doubled the risk of internal bleeding, while there was no discernible impact on heart disease.
The study was conducted on 3,350 people whose blood-pressure tests indicated they had problems with arteries in their legs. Over eight years, 34 people who took a daily aspirin suffered haemorrhages requiring hospital treatment, compared with only 20 such cases among the placebo group. Even more worrying, 14 participants on aspirin developed a stomach ulcer, compared with eight who were taking the dummy pill.
Dr Andrew Green is a Yorkshire-based GP who also works with the charity Sense About Science to help demystify the daily barrage of conflicting health information. “The science part is that we know aspirin reduces people’s risk of heart disease in those who have previously had a heart attack,” he says. “For those people, the potential side effect of internal bleeding is a risk worth taking. But everyone else should steer clear — the risks outweigh the benefits.”
Aspirin may have side effects, but last month another study, from Harvard University, indicated that it could protect against breast cancer. Which research should we pay attention to? “You have to look at the data,” says Green. “That study only found mild benefits. We need to be naturally suspicious of borderline evidence: the risks are too great.”
Risk is a word that’s never far away from the topic of heart disease, possibly because there are so many misconceptions about who is vulnerable. “People mistakenly think heart attacks only happen to men of a certain age — this is not true,” says Judy O’Sullivan, senior cardiac nurse at the British Heart Foundation. “Women are three times more likely to develop cardiovascular disease than breast cancer. And it’s not just postmenopausal women either. If you are in your thirties or forties and you smoke and are overweight, your hormones won’t necessarily protect you. You could be at risk of a heart attack.”
When it comes to preventing heart disease, there are many steps that don’t involve popping a pill. So why did so many people embrace the aspirin remedy? The health psychologist Dr Brian Marien, a former GP, believes there is good reason. “With dramatic health scares that we read about or see on television, such as heart attacks, we feel the need to take action to lower the chances of it happening to us. Frightened people access what are known as ‘safety behaviours’, a quick fix such as taking a tablet. Changing your diet and lifestyle is a much more difficult challenge, so we resort to the pill.”
He also points out that, for some people, taking a pill to ward off an illness gives them a free pass to indulge in unhealthy lifestyle choices. “To use a religious analogy, it’s a bit like going to confession and then feeling free to go off and misbehave until the next time. So it is with health. We take the pills we believe are going to protect us, so then we can revert back to our favourite bad habits, be it overeating, lack of exercise or smoking.”
O’Sullivan has a practical antidote for such naughtiness. “The reason aspirin was such an appealing method is you could take it every day,” she says. “Choose something healthy that you can do on a daily basis instead — one small change such as eating a good breakfast or taking the stairs instead of the lift when you get to work. It’s the habitual choices that make the big difference.”
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The Sunday Times