ASPIRIN: The Pill We May Be Taking Too Far

Aspirin is one of medicine’s most valuable tools, but its usefulness depends on why it is being used,” says Dr Nageshwar Reddy, gastroenterologist and endoscopist, founder and chairman of the Asian Institute of Gastroenterology. Donald Trump’s recent comments on daily aspirin have put the decades-old drug back in the spotlight. Doctors warn against treating a prescription medicine like a supplement. For people with a previous heart attack or clot-related stroke, prescribed low-dose aspirin can help prevent another event. But that does not make it a universal daily pill.

NOT A MAGIC PILL

Aspirin has also drawn interest for possible cancer prevention, with studies suggesting potential benefits in bowel cancer and recurrence in some patients. But Dr Reddy stresses that the evidence supports personalised treatment—not aspirin as a longevity pill.

Studies in healthy older adults have found no improvement in healthy lifespan and have highlighted the increased risk of serious bleeding when aspirin is used without a clear medical indication.

THE GUT WARNING

For a gastroenterologist, the risk is particularly clear.

“Even a small dose of Aspirin to the wrong patient can cause stomach ulcers and gastrointestinal bleeding,” says Dr Reddy.

People with previous ulcers or bleeding problems need to be especially cautious. The fact that a tablet is low-dose does not make it risk-free.

And that is precisely why turning aspirin into a wellness ritual can be dangerous.

HOW ASPIRIN WORKS

Aspirin’s cardiovascular value comes from its antiplatelet action.

Prof. Dr S. Vijay Mohan, Senior Consultant, Internal Medicine & Critical Care explains that platelets help form clots. Aspirin reduces platelet aggregation and inhibits thromboxane A2, making platelets less likely to clump together. This matters particularly in coronary artery disease, where a clot forming over a disrupted plaque can block blood flow and trigger a heart attack.

“Aspirin can prevent platelets from contributing to the final clot formation,” says Dr Vijay Mohan. Its strongest role is in secondary prevention, particularly after a heart attack or in people with established cardiovascular disease, when prescribed appropriately.

NOT FOR EVERYONE

“For healthy people without established cardiovascular disease, the equation is more complicated,” says Dr Vijay Mohan.

Aspirin may reduce certain cardiovascular events, but it also increases the risk of gastrointestinal and intracranial bleeding. The decision therefore depends on an individual’s cardiovascular and bleeding risk.

Diabetes alone is also not an automatic reason to take aspirin. Even among people with diabetes, its use for primary prevention depends on individual risk and bleeding risk.

In short, there is no one-size-fits-all aspirin routine.

THE CELEBRITY TRAP

The temptation to copy a famous person’s health routine is understandable. But medication is not a lifestyle accessory.

“Simply copying a celebrity’s medicine routine is like wearing their prescription glasses,” says Dr Reddy.

The right patient may derive substantial protection from aspirin. Another may face unnecessary bleeding.

The decision belongs with a physician, who can assess medical history, cardiovascular risk, bleeding risk, dosage, duration and other medications. Do not start or stop aspirin on your own.

Aspirin reduces platelet aggregation, helping prevent clots that can trigger a heart attack. But it is not for everyone. Patient selection is critical.”

— PROF. DR S. VIJAY MOHAN