Aspirin May Cause Bleeding in the Brain
It is true that the benefits of low-dose Aspirin for secondary prevention of heart attacks and ischemic strokes are well established in the scientific literature, with the prevention of recurrent ischemic events outweighing the risks of hemorrhage (Gorelick & Weisman, 2005; Baigent et al., 2009). But a recent review has discovered low-dose Aspirin can increased risk of intracranial bleeding, heart attack and death, in individuals with no symptomatic cardiovascular disease. These risks were especially pronounced in individuals with a low body mass index less than 25, or with Asian backgrounds, who had no specific history of heart attacks or cardiovascular conditions, for whom Aspirin had been prescribed as a preventative. (Capodanno & Angiolillo, 2016; Guirguis-Blake et al., 2016; Lei et al., 2016).
It is not warranted to recommend low-dose Aspirin to the general population since the risk does not outweigh the benefit.
Aspirin as a Preventative
Aspirin works by preventing a person’s blood from clotting. Normally, when you bleed, platelets (cells in your blood) build up at the site of a wound and form a plug to stop further bleeding while the wound heals. That’s good. But if a person’s arteries have been narrowed, especially near the heart, from other conditions like atherosclerosis (a buildup of fatty tissues in the arteries) then your platelets can get confused and begin clotting inside the artery itself, blocking blood flow to the heart. This blockage then results in a heart attack.
A daily low-dose Aspirin can help to prevent those clots, thereby avoiding the blockage that would cause such a heart attack.
The Research
The research compared and evaluated thirteen clinical trials with a cumulative total of roughly 134,000 patients, none of whom had a history of stroke or heart disease. Of those participants who took the placebo pill (aka, an inert sugar-pill presented to the participants as Aspirin) 0.46% experienced intracranial bleeds. Those patients who really were given low-dose Aspirin during the trial were more likely to experience bleeding events, with a 0.63% incidence rate. Put another way, all other things being equal, an extra two people in every thousand had intracranial bleeding when taking low-dose Aspirin compared to the control group.
Low-dose aspirin is between 75 and 100 milligrams. It’s in this range that the meta-study uncovered Aspirin’s link to skull bleeding.
Study Conclusions
The benefits of low-dose Aspirin for primary prevention of cardiovascular events is not well supported in the scientific literature. It is actually associated with increased risk of intracranial hemorrhage.
This risk is even worse among Asians and those with a BMI less than 25.
The outcomes of intracranial hemorrhage are often catastrophic.
Serious caution must be taken with the use of low-dose Aspirin in individuals without symptomatic cardiovascular disease.
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As one of nation’s top integrative functional medicine physicians, Dr. Bhandari work with patients suffering from chronic health concerns which modern medicine can only provide side effect-ridden solutions without a cure. By taking the best in Eastern and Western Medicine, Dr. Bhandari understands the root cause of diseases on a cellular level and designs personalized treatment plans which drive positive results. Reach out to SF Advanced Health or call 1-415-506-9393 to learn more.
References
Baigent, C., Blackwell, L., Collins, R., Emberson, J., Godwin, J., Peto, R., ... & Patrono, C. (2009). Aspirin in the primary and secondary prevention of vascular disease: collaborative meta-analysis of individual participant data from randomised trials.
Cadilhac, D. A., Dewey, H. M., Vos, T., Carter, R., & Thrift, A. G. (2010). The health loss from ischemic stroke and intracerebral hemorrhage: evidence from the North East Melbourne Stroke Incidence Study (NEMESIS). Health and quality of life outcomes, 8(1), 49.
Capodanno, D., & Angiolillo, D. J. (2016). Aspirin for primary cardiovascular risk prevention and beyond in diabetes mellitus. Circulation, 134(20), 1579-1594.
Gorelick, P. B., & Weisman, S. M. (2005). Risk of hemorrhagic stroke with aspirin use: an update. Stroke, 36(8), 1801-1807.
Guirguis-Blake, J. M., Evans, C. V., Senger, C. A., O'Connor, E. A., & Whitlock, E. P. (2016). Aspirin for the primary prevention of cardiovascular events: a systematic evidence review for the US Preventive Services Task Force. Annals of internal medicine, 164(12), 804-813.
Huang, W. Y., Saver, J. L., Wu, Y. L., Lin, C. J., Lee, M., & Ovbiagele, B. (2019). Frequency of intracranial hemorrhage with low-dose aspirin in individuals without symptomatic cardiovascular disease: a systematic review and meta-analysis. JAMA neurology.
Kim, H. C., Choi, D. P., Ahn, S. V., Nam, C. M., & Suh, I. (2009). Six-year survival and causes of death among stroke patients in Korea. Neuroepidemiology, 32(2), 94.
Klatsky, A. L., Friedman, G. D., Sidney, S., Kipp, H., Kubo, A., & Armstrong, M. A. (2005). Risk of hemorrhagic stroke in Asian American ethnic groups. Neuroepidemiology, 25(1), 26-31.
Lee, H. Y., Hwang, J. S., Jeng, J. S., & Wang, J. D. (2010). Quality-adjusted life expectancy (QALE) and loss of QALE for patients with ischemic stroke and intracerebral hemorrhage: a 13-year follow-up. Stroke, 41(4), 739-744.
Lei, H., Gao, Q., Liu, S. R., & Xu, J. (2016). The benefit and safety of aspirin for primary prevention of ischemic stroke: a meta-analysis of randomized trials. Frontiers in pharmacology, 7, 440.
AUTHOR
Dr. Payal Bhandari M.D. is one of U.S.'s top leading integrative functional medical physicians and the founder of SF Advanced Health. She combines the best in Eastern and Western Medicine to understand the root causes of diseases and provide patients with personalized treatment plans that quickly deliver effective results. Dr. Bhandari specializes in cell function to understand how the whole body works. Dr. Bhandari received her Bachelor of Arts degree in biology in 1997 and Doctor of Medicine degree in 2001 from West Virginia University. She the completed her Family Medicine residency in 2004 from the University of Massachusetts and joined a family medicine practice in 2005 which was eventually nationally recognized as San Francisco’s 1st patient-centered medical home. To learn more, go to www.sfadvancedhealth.com.