It is time to come clean about aspirin…

  • Aspirin; safe cure or health risk… Discuss!
  • How a misprint put the worlds healthy at risk
  • The way forward… according to Ray

Over the past few months there has been a lot of discussion within medical research circles about the potential benefits of aspirin being over stated.

Maybe the advice that we should all be taking it to avoid a heart attack might not be based upon flawed data.

Despite several claims that small doses of this inexpensive drug can help combat air pollution, diabetes and even cancer (all drawn from published articles in the last month by the way!) the facts are that there may be a big price to pay in terms of our general health.

Here we have one of the most widely used drugs in the world being either hailed as a hero or a villain… how can that be?

Let me explain the back stories on all this.

The Jekyll & Hyde drug story

Aspirin was discovered by Felix Hoffman in 1897 and became one of the first drugs come into common usage. It was prescribed for ailments ranging from headaches to arthritis and heart problems.

About 35 million tonnes of this drug is produced and consumed annually around the world, and that’s a lot of headaches cured!

Initially, no-one was sure how it worked. But, it seemed effective with little or no side effects so it became prevalent in pain relief management. In fact it wasn’t until the 1970’s that we discovered that the active ingredient in aspirin, salycilic acid, blocks prostaglandin production and therefore mediates pain.

This discovery actually earned Sir John Vane a Nobel prize for medicine – a huge endorsement to the power of aspirin.

Over the years, aspirin has been used to treat a variety of conditions including heart problems, kidney diseases and even blindness for diabetes sufferers.

From early in the 1990’s our health service picked up on research from Harvard in the USA and another study in the UK which suggested that people taking aspirin for any reason seemed to have a lower rate of heart attacks.

So, from that point onwards everyone over the age of fifty was encouraged to take a low dose of aspirin to keep their heart healthy.

Then in 2003 a paper was published in the Lancet by a team from Oxford University which concluded that ‘giving daily aspirin to healthy patients whose risk was smaller than heart attack patients would be appropriate’.

QED, as they say in scientific circles – a bunch of scientists say it’s a good thing to give aspirin to everyone, and it will help ward off all sorts of evils.

The big problem was that this article was WRONG! There was nothing at fault with the science, or the methodology of the research… even the statistics was correct and accurate.

The problem came down to a simple spelling mistake.

You know the bit in the quote that said it was ‘appropriate’ to give healthy people aspirin, well it turns out that they meant to say it was ‘INAPPROPRIATE’.

By now the damage had been done, and despite retractions and errata sheets, the nations GP’s were off and running – aspirin for all.

By March 2010, another team of researchers from Oxford had published their trials which showed that healthy ­people shouldn’t take aspirin for their heart, because the risk of internal bleeding is too great.

There’s a great line in their paper which states that if 250 healthy people took aspirin only one would avoid having a heart attack, BUT one person would suffer serious internal bleeding.

I don’t like those odds to be honest!

But is that the full details about the way aspirin can affect the gut? Actually no there is yet more research that offers hope to those suffering from a very serious health problem.

Here’s my take on that story, and my view on what you should do based upon all of this information.

The Collins viewpoint…

Yet another Oxford University Professor has been running a trial to establish what effect aspirin has on bowel cancer incident and death rates.

Prof. Peter Rothwell concludes that in his study those taking aspirin were 24% less likely to develop bowel cancer, and if they already had it they were 35% less likely to die from it.

Considering this form of cancer affects upto 16,000 people per year, making it the third most common malignancy, those statistics start to look really impressive.

I can understand why the feature writers might be interested in 4,000 fewer cases per year.

The issue is that it may not work out that way.

A more general view suggests that it is way too early to begin to use aspirin as a blanket preventative for bowel cancer, sure the study states that only 2.5% of those taking aspirin contracted the condition, against 4% of those not taking it – but is this a big enough change to outweigh the risk of bleeding?

Most specialists in the treatment of colorectal disorders don’t think so, for instance Professor Dion Morton, a surgeon at University Hospital Birmingham says that unless two of your immediate relatives have developed the problem you shouldn’t even think about taking aspirin.

So, it looks like they are going to need more research, let’s hope that they do come up with something conclusive that helps GP’s and sufferers make the right decisions.

More importantly, I hope that their editor doesn’t allow a stupid spelling mistake to misdirect the advice given. (Enough of the editor attacks Ray… I have the power to make you sound really stupid! Ed)

Just as a last thought on this story though… and to prove what a contrary fellow I am!

Aspirin is a very inexpensive medicine which is now out of patent so can be produced widely without huge royalty payments being made.

If its use was to be rubbished then what would those who were at risk of coronary heart disease, heart attacks or strokes have to rely on?

Chances are it would be a much more expensive alternative that would make its licence holders a great deal of money.

Sometimes the truth in these stories is not quite so obvious as it first seems, so I would not be unduly worried if you are a regular aspirin user.

But I would ask my GP about its continued use in the light of the latest news and research… if it turns out that it is the right thing for you on balance, then carry on.

Yours, as always