Aspirin is taken by many people every day. It can be very helpful. We also know that aspirin has side effects, some of which can be serious. Nevertheless, doctors are recommending aspirin to many people with heart and blood vessel disease.

Aspirin is a drug derived from the bark of silver birch trees. It has potent anti-inflammatory activities and can relieve pain and inflammation in muscular and joint disorders. Aspirin will help reduce high temperatures (although paracetamol is safer). There are similar drugs-ibuprofen for example. Other anti-inflammatory drugs can be prescribed by your doctor. All these drugs can cause side effects. Ibuprofen is the safest and is available from the chemist without prescription.

Side effects

These drugs can cause ulcers and inflammation in the stomach. This can lead to indigestion pains and sometimes bleeding. Aspirin and the other anti-inflammatories can trigger asthma. They should not be used by patients with asthma. Other rare side effects include kidney damage. Aspirin cannot be used in children because it can cause a serious disease called Reye's syndrome. This affects the liver and brain when the drug is given to children with a high temperature.

Aspirin and heart disease

With all these problems, should aspirin be used at all? The answer is definitely yes, for some conditions. Aspirin helps patients with heart and blood vessel disease. We know that at very low doses aspirin make the blood less sticky and less likely to clot. A heart attack and most strokes occur when a blood vessel is blocked by a clot of blood. Usually the clot blocks an already narrowed blood vessel that has been 'furred up' over the years by a process called atherosclerosis. Atherosclerosis is caused by high cholesterol and smoking. It is better not to develop 'furred up' arteries in the first place by avoiding smoking, exercising regularly and keeping to a healthy diet. However, if you already have problems then low dose aspirin may prevent fatal complications. By making the blood less sticky taking aspirin reduces the chance of blood clotting in these diseased blood vessels. Your risk of stroke or a heart attack is reduced.

Several large scale studies have shown that patients with blood vessel disease definitely benefit from low dose aspirin. However, there is not enough evidence yet to recommend aspirin to healthy adults. Patients taking aspirin are more likely to bleed when injured and may have an increased tendency to bleed internally. For healthy people without blood vessel disease, these risks may outweigh the benefits.

A low dose is all that is required

The dose of aspirin required to make the blood less sticky is very small. In fact half a junior aspirin (75mg) is all that is required and more is not better in this case. This low dose is unlikely to cause indigestion. We recommend aspirin to all patients with angina, heart attacks, heart valve or heart rhythm problems and for patients with blood vessel disease in the legs and certain types of stroke and blackouts. These patients should take 75mg of aspirin every day, for the rest of their lives providing they do not experience any complications such as bleeding or bruising.

Suitable for most people

A few patients should avoid this low dose treatment. These include those with an allergy to aspirin that causes swelling of lips and tongue or severe rash, or those whose asthma is triggered by aspirin. Patients with active stomach ulcers that have not received treatment yet should also avoid aspirin. Patients taking other blood thinning treatment like warfarin should consult their doctor before starting aspirin as the two can interfere with each other and this might be dangerous. Everyone else with heart or blood vessel disease should take aspirin 75mg daily. Buy it or ask for a prescription-it really does save lives!