Aspirin As Blood Thinners: Are They Safe?
Aspirin as blood thinners have a long way to go. They are, possibly, the most indicated drug in primary health care for patients with cardiological risk.
For decades, its use as a preventive drug for cardiovascular events has become popular. Thus, many health professionals, without being able to justify the fundamentals with certainty, prescribe aspirin as anticoagulants and indicate them for chronic and prolonged use.
The truth is that aspirin, more than anticoagulants, are antiplatelet agents. The point of action within the blood is different. While anticoagulants interfere with substances such as clotting factors, antiplatelet agents slow down platelets.
This difference, which is not minor, is the one highlighted by scientific studies that seek to analyze the safety of the drug. In the same way, the effectiveness is analyzed, to determine if it is worth taking this drug every day of life.
The uses of aspirin
When we talk about aspirin as anticoagulants we are in the field of long-term and chronic use. However, there is also acute and time-limited use of this drug for pain and fever.
Although it is worth clarifying that on the subject of pain, some patients use them in the very long term. Take the case of rheumatoid arthritis, with acute arthralgia throughout life. While the patient may take an aspirin today for the pain of the day, he will likely repeat it tomorrow, and so on.
The specialty of rheumatology is very prone to the use of aspirin as an analgesic. As we have already mentioned, it is indicated in rheumatoid arthritis and lupus. Without being an autoimmune disease, osteoarthritis is another clinical picture that benefits from the analgesia of this drug.
Its use to reduce fever, on the other hand, tends to become obsolete. New nonsteroidal anti-inflammatory drug options have taken place, such as ibuprofen. Today, pediatricians often prescribe the latter to regulate temperature.
Finally, for chronic use, aspirins are understood as anticoagulants. Patients with cardiovascular risk are instructed to take one daily for the rest of their lives. This theoretical knowledge is so popular that many people take a daily dose without consulting a health professional.
A meta-analysis on aspirin as blood thinners
A meta-analysis-type study, published in the European Heart Journal in 2018, evaluated the safety and effectiveness of aspirin as anticoagulants in non-cardiac patients. The objective was to know if there was a significant decrease in mortality.
The follow-up of the patients was more than 6 years, and in the group it was found that the incidence of acute myocardial infarctions decreased. This means that the use of aspirin could prevent these cardiac events.
However, overall mortality in the meta-analysis subjects did not vary. That is, at the end of the follow-up, although there was a lower incidence of myocardial infarctions, the number of dead individuals was the same as if they had not used the drug for all that time.
On the contrary, more adverse effects were recorded among users of aspirin as anticoagulants. The group had more hemorrhages, particularly intracranial.
The authors of the meta-analysis suggest, then, that aspirin prescriptions should be re-evaluated for certain patients, since they would not provide extra benefits. In addition, you would run the risk of unwanted effects.
Aspirin for pain and fever is safe
Another meta-analysis evaluated the acute use of aspirin for its safety. As acute use we mention its use in pain and fever in a single dose.
This survey of more than 60 diverse clinical trials concluded that adverse effects were very few. A special focus was placed on gastrointestinal symptoms derived from non-steroidal anti-inflammatory drugs, and aspirin was found to add 1 unwanted effect for every 111 patients who consumed it.
The meta-analysis clarifies that it is a study on the acute use of the drug, and does not assess aspirin as anticoagulants. In this sense, for fever and pain, there would be no insecurity profile.
Aspirin as blood thinners are not safe
With the accumulated scientific knowledge in this regard, today it can be said that the indiscriminate use of aspirins as anticoagulants should not be promoted.
Each case must be evaluated in particular, especially in patients with a cardiac history, who would benefit the most from its use. In the general population, it is not clear that this drug is beneficial in prolonging life.
