The idea that an aspirin a day keeps cardiovascular disease at bay is quite firmly entrenched in the collective psyche. The idea was first touted by the FDA over a decade ago and has been widely publicised in the media.

The recommendation, as it stands it to take low dose aspirin, usually < 100 mg. The low dose can be achieved by taking an aspirin tablet formulated for a child, often referred to as a “baby” aspirin or splitting a standard aspirin tablet in half.

The emphasis is on taking a LOW dose, because high doses of aspirin can be quite hard on the stomach and increase the risk of bleeding etc.

“Baby” Aspirin a day ritual

Millions of people, around the world, have faithfully swallowed their baby aspirin, believing this easy, safe and relatively cheap ritual, would protect them from a heart attack or stroke.

The little pill gets to work interfering with the ability of the platelets to clump together.  Clumped up platelets create floating plugs which block up blood vessels.  Blockage of an artery in the heart, leads to a heart attack, while obstruction of brain blood vessels, precipitates a stroke.

The baby pill is strong enough to hurt the platelets, but too weak to hurt anything else, so taking a baby aspirin a day is more or less side effect free.

Low dose advantage gone in diabetes

Researchers from University of Alberta decided to take another look at the aspirin and its cardiovascular disease fighting powers. They decided to particularly look at how helpful aspirin was in diabetic patients, since diabetics are particularly at risk from blood vessel troubles.

They looked at data from 21 studies that had used aspirin in diabetics in a type of study known as a meta-analysis. A meta-analysis is considered to be an especially valuable type of study because it looks at lots of people. The more people included in the analysis means that you can be more confident that the results of the study are accurate.

As expected, aspirin did work BUT it didn’t work at the low doses. The benefit in diabetic patients really only kicked in at higher doses – the magic number was 325 milligrams per day.

NOTE : When people took the extra aspirin, they still could suffer from a heart attack or a stroke but the odds of it happening were reduced a little, so taking aspirin reduced risk but didn’t stop it.

Dump the “baby” aspirin

If you are a diabetic and are faithfully swallowing a baby aspirin everyday, you’re probably not taking enough to really benefit.

To protect yourself, you need to increase the dose so that you are taking at least 1 normal tablet everyday. But remember, if you take more aspirin, you are more likely to suffer from bleeding problems especially in your stomach.

Risks versus Benefits

Every chemical that is pharmacologically active has risks and benefits. When you opt to take any chemical, you need to be weighing up the risks versus benefits and consider alternatives.

In the case of higher doses of aspirin………

The benefit

Decreased platelet aggregation i.e. platelet clumping which decreases your chances of suffering from a heart attack and/or stroke. Both heart attack and stroke can kill you or leave you alive but with very poor quality of life.

The risk

The big problem is gastrointestinal bleeding which can lead to ulcers and extreme stomach discomfort. There are things that you can do to decrease the problem.

Here a few tips and tricks to minimize stomach troubles when taking aspirin which would lower the risk.

PS. There is a list of other problems which can occur in some people. One that is worth noting is taking aspirin will prolong bleeding times – this can be a problem if you are injured or have surgery but it can be handled relatively easily.

Alternatives

There are lots of things you can do to decrease your risk of a heart attack

• Exercise
• Brush your teeth regularly
• Keep blood pressure, sugar levels etc in normal range

But these alternatives are not quite as easy as taking a pill. Are there any pills that might do the same thing as aspirin but not have the same risks ?

Magic pills to beat the odds ?

The cardiovascular power of a pain killer (aspirin) unplugged explains exactly how aspirin works. Ultimately it fiddles with your eicosanoids.  Swallowing omega-3 pills does the same thing without the nasty side effects.

The other pill which decreases the odds of a blockage because it makes blood vessels a little more flexible, is Vitamin D. Vitamin D checks in with a host of added benefits at physiological doses.

Does it make financial sense ?

The aspirin option will definitely work out cheaper than supplementing with the other pills.

A quick calculation based on South African prices

• an aspirin a day at around 65 c
• an omega-3 capsule is around 90 c (you probably need to take more than 1 capsule to get full benefit)
• a Vitamin D (2000 IU) tablet is around R 1.00

NOTE : Vitamin D is actually free if you spend some time in the sun but in we are looking at tablet options.

What should you do ?

In my opinion, the best option from a pharmacological perspective would be to switch to omega-3 and vitamin D supplement. It may cost more, but it comes with additional health benefits and fewer risks.

Further reading

Tweedle dum and tweedle dee lacked fat cell membrane synergy	Fat cells lock in vitamin D potentially short changing health in the overweight	Why infections are difficult to overcome in diabetics

Interested in learning more about the chemistry of diabetes ?

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Did you learn something new or do you have a different perspective ? I’d love to hear from you so post me a comment below…..