ASPIRIN is one of the most commonly used medicines worldwide, both prescribed by doctors for clear indications, but also bought over the counter by millions of individuals with the belief that this once-a-day tablet is helping them to prolong their life and prevent numerous ailments.

However, a recent study following 20,000 US and Australian patients, with an average age of 70, for a total of five years, showed that in those who were fit and healthy, aspirin showed no decreased risk of heart attack, stroke or the development of dementia. Yet it did confer an increased risk of serious internal bleeding, both in the stomach and brain, suggesting that millions of people who do not need to be on aspirin may be unnecessarily putting themselves at risk.

A precursor of aspirin, extracted from the leaves of the willow tree, has been used medicinally for more than 2,500 years, with aspirin itself becoming available in 1899. Since then its popularity and use has increased massively.

There is no doubt that aspirin is a life saver, and indeed it is the only medicine available that treats acute pain, as well as being used in the management of heart attacks, strokes and peripheral vascular disease.

Aspirin works immediately on pain by reducing inflammation and swelling associated with an injury, as well as lessening the unpleasant effects of a fever.

In a heart attack or stroke, a fatty deposit in the wall of a blood vessel ruptures. Platelets are attracted to the site to heal this defect, but if several platelets clump together, the vessel may block entirely, with blood completely unable to flow past. Aspirin works by reducing platelet activity and hence is used while a patient is having a heart attack or stroke, and continued after the event to reduce the chance of a further episode.

While there are clear indications for using aspirin, there are many where it is less appropriate or where more suitable alternatives exist.

Aspirin is no longer recommended in the management of the irregular heart beat condition, atrial fibrillation.

It is not advised in anyone under the age of 16, due to the risk or Reye’s syndrome, a potentially life threatening illness that may cause brain and liver damage.

For acute pain, it may be safer to consider paracetamol as your first line treatment.

Aspirin can worsen certain conditions, including asthma and indigestion, and as a member of the family of nonsteroidal anti-inflammatory drugs (NSAIDs), should not be taken at the same time as any other, notably ibuprofen.

If you have been prescribed aspirin, either by your hospital specialist or general practitioner, I would strongly advise you to stay on it, as your medication has been prescribed for a clear reason, where the benefits outweigh the risks. However, if you are purchasing aspirin over the counter and do not have a condition for which it is definitely needed, it may be worth discussing this with your own doctor to see if you still need to be on it, or whether it is safer to stop.