2024-01-20 07:17:35
Aspirin has a reputation for preventing strokes. But this benefit of the drug is now controversial. What you should know about the topic.
Aspirin has a reputation as a miracle cure: The white tablet with the active ingredient acetylsalicylic acid (ASA for short) is a bestseller for the Bayer Group and is swallowed to treat headaches, fever or inflammation. However, doctors have long assumed that the blood-thinning agent helps against and can prevent strokes. That’s why many people take an aspirin tablet every day as a preventive measure. But research is not entirely sure about the effectiveness of this medication. It is possible that the side effects could cause more harm than good in healthy people.
Aspirin for stroke: Helpful – but controversial
Bayer advertises its world-famous drug, which has been on the market for more than 120 years, as “surprisingly versatile.” And the German Medical Journal actually describes the active ingredient ASA as an integral part of the treatment of cardiovascular diseases. Patients who have already suffered a stroke are usually prescribed aspirin in a dose of up to 100 mg per day, according to the specialist magazine.
Particularly in the USA – but also in Germany – the drug is also taken every day as a preventive measure, although there is still no identified risk of stroke. Even the U.S. government’s Appointed Disease Prevention Experts (USPSTF) had long recommended certain age groups take aspirin daily to reduce the risk of a heart attack or stroke. But only until 2022, then they withdrew their recommendation. In recent years, various studies have only been able to prove a benefit for patients who have already had a heart attack or stroke. In addition to positive effects, the active ingredient could also “potentially cause serious harm,” USPSTF representative John Wong previously stated publicly. And the benefits of the drug are not sufficient to offset this increased risk.
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Aspirin for stroke: What dangerous side effects are possible?
“Because the role of aspirin in primary prevention is unclear, there are sometimes even contrary recommendations,” write cardiologists Sean Zheng from Imperial College and Alistair Roddick from King’s College in London in an analysis in the medical journal JAMA. Researchers understand primary prevention as the prevention of disease. The potential harm is similar to the potential benefit: taking aspirin daily increases the risk of major bleeding by 0.47 percent. Although that doesn’t sound like much at first, the benefit is less: the preventive measure only prevents a cardiovascular incident by 0.38 percent.
In addition, aspirin can weaken the body elsewhere: “Aspirin is a drug that inhibits the formation of special proteins in the stomach and in the mucous membrane of the intestine,” explained gastroenterologist Matthias Ebert from the Mannheim University Hospital to the SWR. These proteins protect the mucous membrane in the intestines and stomach. If this protein is inhibited, it can cause mucosal injuries and severe bleeding.
Prevent stroke with aspirin: study results dampen the good reputation
One Study on behalf of “Aspree” (Aspirin in Reducing Events in the Elderly) examined the effectiveness of aspirin against cardiovascular disease in older people. The average age of the participants – around 19,000 healthy people in the USA and Australia – was 74 years. They were divided into a group that took aspirin as a preventive measure and a placebo group that did not take aspirin as a preventive measure.
The study ran for around five years until the researchers took stock: there was no significantly lower risk of cardiovascular disease in the aspirin group, but there was a significantly increased risk of bleeding. Mortality in the ASA group was even slightly increased compared to the placebo group. Fatal cancer and gastrointestinal tumors were more common among aspirin participants.
The so-called “Ascent” study from 2018 in the New England Journal of Medicine also produced mixed results. The study analyzed the low-dose use of aspirin in diabetes patients – who are also at risk of stroke – over seven years. In fact, fewer strokes and other cardiovascular diseases were recorded here – but the number of serious bleeding, for example in the brain or eyes, increased.
Aspirin for stroke: neurological side effects
Additionally, regular high doses can lead to neurological symptoms such as Science magazine Spektrum explains: ringing in the ears, headaches, blurred vision, drowsiness, dizziness, confusion. The active ingredient could also be dangerous for people with asthma because it increases the narrowing of the bronchi.
Conclusion: Can aspirin prevent a stroke?
Even though ASA is used as a medication for existing cardiovascular diseases and in therapy after strokes, broad studies do not show any significant benefit in preventing strokes – but rather show that the harm caused by severe bleeding slightly outweighs the harm. Broke in 2014 Japanese doctors conduct their study with around 15,000 participants even ended prematurely because those who took aspirin had hardly fewer heart attacks, but more bleeding. In general, even healthy people should consult a doctor beforehand about taking medication regularly.
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