Talking a low daily dose of aspirin has long been a recommendation for heart health, and many of us pop a Tylenol or an Advil to knock out a headache, muscle ache, arthritis pain, or menstrual cramps. Because of the accessibility of over-the-counter (OTC) medications like aspirin, acetaminophen, and ibuprofen, many may think nothing of grabbing a pill to ease what ails us, or, in the case of aspirin, to actually improve our long-term health and reduce our risk for disease.
Weighing Asprin’s Bleeding Risks Against Its Heart Benefits
Organizations like the American Heart Association recommend aspirin for people who are at higher risk of cardiac issues such as heart attack or stroke. But since it is a blood thinner, aspirin is known to elevate risk of bleeding, which can be serious and could potentially outweigh its benefits.
Doctors agree that not everyone should take aspirin as a preventative measure to reduce heart risk, according to the authors of a new study, but there is little consensus about the point at which the benefits outweigh the risks, even for those at higher likelihood of having a cardiovascular event. A team of researchers looked at whether low-dose aspirin taken over the long term reduced the risk of cardiac events in women above and beyond the risks it posed.
The study set out to determine this balance point, by tracking the heart health over a decade of almost 28,000 women who had taken part in the Women’s Health Study. Half of the participants took an average of 100 mg of aspirin every other day; the other half took a “dummy pill” (placebo).
Overall, the risk of having a stroke, heart attack, or dying of a cardiac issue was reduced from 2.4 to 2.2 percent in the women who took aspirin, compared to the control group. This reduction is not huge. And some of the participants in the aspirin group suffered from bleeding problems, like gastrointestinal bleeding, peptic ulcers, or easy bruising.
Acetaminophen: Slow And Steady Doesn’t Always Win
It’s not only aspirin that’s under the magnifying glass. Many of us think that acetaminophen, such as Tylenol, is far safer than aspirin. But a recent study found that even low-dose acetaminophen over the long term can be even more damaging to the body than a high single dose.
When researchers analyzed the records of 663 patients who had been treated for liver toxicity at a Scotland hospital, they found that 161 of them had taken a “staggered overdose,” a low, chronic amount, usually to deal with recurrent aches and pains like muscle aches, headache, and toothache. The continual use had damaged their livers as their bodies struggled to remove the chemical day in and day out.
Staggered overdose patients were also more likely to suffer brain and kidney as well as liver problems compared to patients who had taken a large single dose of acetaminophen. They were also at higher risk of having to be on a breathing machine — and, surprisingly, they had a greater risk of dying.
Appropriately, earlier this year the Food and Drug Administration (FDA) urged all makers of acetaminophen to reduce capsule strength to 325 mg of the drug, and to display a boxed warning on the packaging, outlining the risk of liver damage. Considering the number of people who use acetaminophen for common aches and pains such as arthritis, rethinking the dosing and marketing of the drug is likely a wise move.
Ibuprofen: A Better Bet or Just As Risky?
Other recent research has looked into the safety of other go-to pain medications, like non-steroidal anti-inflammatory drugs (NSAIDs) including ibuprofen. Unfortunately, while it is generally safe, this common OTC painkiller also has its downside.
One study found that certain NSAIDs can pose significant risks to the heart: regular use of OTC ibuprofen was linked to greater risk of stroke — up to 29 percent, for both fatal and non-fatal forms. Other, newer research has found that use of OTC ibuprofen at very low doses may double the risk of miscarriage in the first trimester of pregnancy. The NIH warns that even ibuprofen and naproxen (Aleve) can cause bleeding, ulcers, heart attack, stroke, and sudden death. Aspirin and ibuprofen can also interfere with the action of antidepressants. The adverse events associated with NSAIDs are uncommon, but they do exist and can be unpredictable.
Author Information: RTPR.com
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