HAILED as a pill for all ills, aspirin is one of the oldest medicines on the market. The name

Aspirin was trademarked by the German pharmaceutical company Bayer over 100 years ago, yet acetylsalicylic acid, extracted from plants including willow and myrtle, has been used as far back as 4,000 years.

It is easy to see why it has garnered such enthusiasm. As the first discovered non-steroidal anti-inflammatory drug it is an effective painkiller for ailments as diverse as cold and flu symptoms, joint and muscle aches as well as menstrual pains and migraines. As an anti-clotting agent, it prevents platelets clumping together, one of the pathways that results in complete blockage of a blood vessel during heart or stroke.

ALSO READ: Resident GP Dr Zak gets to the heart of the matter

Easily available over the counter, it and paracetamol are the go-to drugs if you need analgesia, but don’t want the numerous unpleasant side effects associated with stronger painkillers.

The role of aspirin in acute cardiovascular events, such as suspected heart attack and ischaemic stroke (that caused by a blocked blood vessel), as well as in secondary prevention, to reduce the chance of a further incident are established and agreed.

It is also approved in the treatment and prevention of repeat deep vein thrombosis and pulmonary embolism, as well as atrial fibrillation.

Daily Echo:

However, advice is changing as to the role of aspirin in preventing a first heart attack or stroke, known as primary prevention, even in those with risk factors.

The American Preventative Services Task Force has issued draft guidance advising older adults, classified as those over 60, shouldn’t take low dose daily aspirin to prevent a heart attack, as the risks of bleeding outweigh any potential benefit.

The evidence is that low dose aspirin may benefit those in their 40s with risk factors for heart attack and stroke, but without risk factors for bleeding, yet by the time individuals reach their fifties, risks may outweigh benefits.

Although this contradicts the same body’s guidance from 2016, it must be remembered that scientific developments will often challenge and indeed make obsolete previous recommendations.

Thankfully the UK Guidelines on aspirin are pleasingly clear, reminding us aspirin is not licensed for the primary prevention of cardiovascular disease (CVD), with other medications such as statins for raised cholesterol, as well as lifestyle modifications first line.