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We've long known that aspirin reduces the risk of heart attacks and strokes while increasing your chances of surviving them. But now this household drug may protect you in other ways, too. 

Newer evidence indicates that aspirin can also reduce the risk of cancer of the colon, esophagus, stomach, rectum, and prostate. And most recently, the humble aspirin has offered the tantalizing possibility that it may help protect against Alzheimer's disease. With all of these potential benefits, why aren't we dumping aspirin in the water as we do with fluoride? 

When you take aspirin, the level of stomach protection is decreased and you’re more likely to bleed. Thus people who take aspirin regularly –even in a buffered or coated form – will have roughly double the likelihood of perforated ulcer or bleeding in the GI tract. Relatively little attention is paid to this problem that kills more people in the U.S. each year than asthma or cervical cancer. What we need to do is focus less attention on finding more things that make aspirin look good, we have plenty of those, and think more about focusing on how to minimize risk. 

So how do you decide whether or not a regular, preventive dose of aspirin is right for you? There's no simple formula, unfortunately. In the case of aspirin, the decision is multifactorial and requires a lot of thought.

Those patients most in need of daily aspirin therapy are easy to identify. If you have a documented personal or family history of heart disease -- including heart attacks, stokes, or angina; if you have diabetes; or if you have multiple risks for the development of heart disease such as have high blood pressure, high cholesterol, or are a smoker, you should most likely take a daily dose of aspirin Although the optimal dose of aspirin in prevention of future heart disease is still unclear, doses of 75 milligrams, 100 milligrams, or 325 milligrams have been found to be equally effective. 

Studies reviewed by the U.S. Preventive Services Task Force have shown that daily or every-other-day aspirin therapy reduced the risk of coronary heart disease by 28%in persons who had never had a heart attack or stroke, but who were considered high-risk individuals.

It is imperative to discuss aspirin therapy with your physician to determine if this is an appropriate course of action for your medical status. 

---James G. Scelfo, MD