Long-Term Side Effects Of Aspirin Use That Aren't Widely Discussed

You might have heard some people talk about taking aspirin daily. While we generally turn to this drug to treat aches and fever, some use it as a way to decrease their risk of heart attack or stroke. However, regular use of aspirin can lead to adverse side effects as well, ranging from bruising easily to gastrointestinal bleeding and stroke. Therefore, it is vital to speak with your physician about how you should interact with aspirin before electing to take it every day.

It might surprise you to know that aspirin, also known as acetylsalicylic acid, has been around since the 1890s. Typically, aspirin is taken to alleviate symptoms such as fever, pain, and inflammation. In fact, salicylates — the class of drugs to which aspirin belongs — have been used to relieve pain for millennia. Salicylates can be found in willow bark and leaves and were given to reduce pain in ancient China and Greece. Later, in the 18th century, it was found that dried willow bark could also bring fevers down. But it wasn't until the end of the 19th century that chemist Felix Hoffman synthesized pure acetylsalicylic acid that later was made publicly available as aspirin.

But there was still a piece missing. In the 1960s, researchers discovered that aspirin also exhibited blood-thinning properties. This discovery would pave the way for understanding how aspirin could help prevent cardiovascular disease. Of course, we know now that this preventative treatment can come with some tradeoffs.

To fully understand the anti-clotting properties of aspirin, we need to first grasp its biochemical mechanism. Aspirin inhibits an enzyme called cyclooxygenase. The important thing to know about this enzyme  is that it is a precursor for thromboxane A2, which promotes platelet formation. Platelets are the component of blood that can stick together to thicken the blood and form a plug at the site of an injury. These little guys are what prevent you from bleeding out when you get a cut or have a nosebleed.

As with most things, balance is key. Too many platelets can lead to blood clots, which can result in a heart attack or stroke. On the other hand, too few platelets can lead to excessive bleeding as there is nothing to form a plug and prevent continued blood flow. In the case of aspirin, a small dose is enough to reduce the production of thromboxane A2 and lower platelet levels. Importantly, thromboxane A2 is not the only promoter of platelet production, nor is it the most powerful. So, taking baby aspirin is not likely to cause you to bleed out, and can be beneficial in certain cases. With this in mind, physicians typically only recommend daily low-dose aspirin if you have a high risk of cardiovascular problems, are between the ages of 40 and 59, and have a low risk of excessive bleeding.

It is important to note that taking the suggested dose of aspirin once in a while is not likely to result in any long-term issues. It is consistent use and/or high dosages that can lead to complications. Aspirin does have blood-thinning properties, and while this is helpful in certain cases, it can be risky in others. If there are too few platelets, what might otherwise be a minor injury can become something very serious.

Hemorrhagic strokes occur when a ruptured vessel causes blood to pool in the brain. These are very serious, and studies have shown that daily use of aspirin increases the risk of developing a hemorrhagic stroke, especially in patients with a history of high blood pressure. Although there have been some studies with opposing results that suggest aspirin does not significantly increase the risk of hemorrhagic stroke.

Another risk factor associated with regular aspirin intake is the development of gastric ulcers. These are sores that form in the lining of the stomach and can result from irritation caused by aspirin. This risk is exacerbated by taking aspirin with other medications, such as naproxen sodium (Aleve). Therefore, it is useful to consider the long-term side effects of Aleve as well.

It is best to consult your physician before deciding whether to regularly take aspirin. Additionally, age is an important factor to consider. Children under the age of 18 should not be given aspirin unless otherwise recommended by a healthcare provider.