Aspirin, used for centuries as a pain reliever, has only been recognized as having benefits for the heart in the past several decades. In the following video, Dr. JoAnn Manson, Chief, Brigham and Women’s Hospital (BWH) Division of Preventive Medicine; Co-Director, Connors Center for Women’s Health and Gender Biology; and Co-investigator, Nurses’ Health Study, Physicians’ Health Study, and Women’s Health Study, describes the discovery by BWH researchers that aspirin could prevent first heart attacks, saving lives worldwide.

Heart Attack Prevention in Men

Due to aspirin’s ability to thin the blood and prevent platelets from clumping, clinical researchers concluded, in the late 1970s, that aspirin could help prevent heart attacks in people who had suffered them previously. Several randomized trials demonstrated this benefit in high-risk individuals.

In 1980, BWH researchers launched the Physicians’ Health Study to test whether aspirin could reduce the risk of a first heart attack or other cardiovascular event in the general population. In the study, approximately 22,000 male physicians, ages 40 to 84, were randomly assigned to either a low-dose aspirin group or a placebo group.

Comparing data from the aspirin and placebo groups, BWH researchers found a statistically significant 44 percent reduction in the risk of having a first heart attack and an 18 percent reduction in the risk of all cardiovascular events. Data collected from the Physicians’ Health Study did not demonstrate that aspirin lowered the risk of a stroke.

These findings indicated, for the first time, that aspirin could be used as a primary prevention of heart attacks and other cardiovascular events in men.

Aspirin and Heart Health in Women

In 1993, BWH researchers began the Women’s Health Study to examine the effect of low-dose aspirin on the risk of cardiovascular events in healthy women. The Women’s Health Study had a design similar to the Physicians’ Health Study, this time focusing on about 39,000 female health professionals ages 45 and older.

Data collected from the Women’s Health Study indicated that women 65 and older saw a reduced risk of heart attack and major cardiovascular events with aspirin, while there was little evidence to indicate heart benefits for women under 65.

Based on the results of the study and the side effects associated with taking aspirin, researchers concluded that women under 65 should not be treated with aspirin for cardiovascular disease prevention unless they were considered at high risk for a cardiovascular event. For women over 65, BWH researchers found a reduction in risk of both heart attack and stroke with regular use of low-dose aspirin.

Exploring New Uses

Research at BWH and other locations continues to investigate additional benefits of aspirin. Data collected from the Nurses’ Health Study indicate that prolonged use of aspirin may play a role in reducing the risk of colorectal cancer. Emerging evidence from other studies being conducted in Boston and elsewhere suggest that aspirin also may reduce the risk of breast cancer or prevent recurrence or death from breast cancer in women with a history of the disease.

Aspirin appears to have other benefits as well. Research from the Women’s Health Study suggests aspirin may lower the risk of age-related macular degeneration, a major cause of vision loss, but the findings are not conclusive and additional research is needed. A few studies also indicate that individuals who take aspirin regularly may have a slower decline in cognitive function and less memory loss as they age.

Balancing the Risks and Benefits

It’s extremely important to speak with your physician before taking aspirin on a regular basis. Despite its many benefits, the use of low-dose daily aspirin is not without risks. Regular aspirin use can increase the risk of gastrointestinal bleeding and hemorrhagic stroke due to its blood thinning properties. Your physician can help you determine if the benefits of long-term aspirin use outweigh the risks based on your detailed health history.

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– Jamie R

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