The aspirin regimen isn't an automatic

Aspirin has been around for centuries. It was originally derived from the willow tree. Hippocrates used it to treat fever. I fondly remember having to make the compound in college chemistry class. I did not sample the end product, but I think it turned out OK.

Today it still has many uses. Aspirin has been a life-saving medicine for those people who have struggled with cardiovascular disease such as heart attacks and strokes. We give aspirin immediately to anyone we think is having a heart attack because it can stop the heart attack at that time and limit the damage. After a heart attack, it has been shown to prevent the next heart attack. The data is similar for recurrent stroke prevention.

When I was in medical school, there was talk of having all males taking aspirin from age 35 to help prevent cardiovascular disease. Over the years, that recommendation has been toned down and slowly refined as we began to study the benefits and the risks of aspirin. Aspirin may seem harmless but there are real drawbacks to the drug. The most concerning side effect is bleeding. This can be minor or major.

The latest guidelines recommend that we do not start aspirin for prevention on anyone older than 70 due to the risks of bleeding and the limited data on how it will benefit the person.

For people between the ages of 50 and 69, the role of aspirin is based on individual risk. It is recommended that we calculate the risks and decide if aspirin is of potential benefit. It is easiest to use a computerized risk calculator that factors in age, sex, cholesterol, blood pressure and diabetes. We look at these factors combined and if the risk of a cardiac event in the next 10 years is more than 10 percent, then aspirin is recommended.

Needless to say, the simple question about taking an aspirin a day is not so simple as it was before. This a good thing. Over the years, medicine has tried to individualize care and patients are encouraged to weigh in on what they want while knowing the risks and benefits of certain treatments.

So should I take an aspirin a day, Doc?

Let’s talk about it.

Dr. Ken Ripp is a family medicine physician at the Raiter Clinic in Cloquet.