For many, taking an aspirin is a no brainer, a simple way to protect against cardiovascular disease.

The problem is that aspirin causes many uncomfortable and possibly dangerous side effects.

In addition, a little known phenomenon called aspirin resistance means that, for some people, aspirin provides no protection at all.

There is no single laboratory test for aspirin resistance and the estimates of how many people are aspirin resistant vary widely from as low as 5.5% to as high as 60% according to a recent study in Journal of the American College of Cardiology.

Aspirin belongs to a class of drugs called “nonsteroidal anti-inflammatory drugs” NSAIDs.

They work by inhibiting the enzymes that make prostaglandins, chemicals that promote inflammation, pain and fever, and are necessary for blood clotting.

People often think of aspirin as a completely benign substance.

It is not.

Here are some of its side effects which may surprise you:

• Gastrointestinal bleeding.  In the US, about 103,000 hospitalizations and 16,500 deaths occur every year from gastrointestinal bleeding related to NSAIDs, including aspirin.
• Dyspepsia.  This condition, which is characterized by pain or discomfort in the upper abdomen, is reported by 12% of users of aspirin and other NSAIDs.
• Gastroduodenal lesions.  In a study of arthritic patients taking NSAIDs for pain, 30% developed painful gastroduodenal lesions or sores in the stomach and/or small intestine.
• Cataracts.  Prolonged aspirin use can increase risk for cataracts (hardening and clouding of the lens of the eye) by 55%, according to a study in Ophthalmology.

NSAIDs can also interfere with the treatment of high blood pressure.

NSAIDs are among the most commonly used drugs for osteoarthritis and other painful conditions.

“Traditional” NSAIDs are a central part of pain management and include Advil, Medipren, Motrin, Nuprin, Aleve, Anaprox, Naprosyn, and COX-2 inhibitors such as Celebrex.  All of these agents have potentially serious side effects.

NSAIDs can cause gastrointestinal toxicity and life-threatening gastrointestinal hemorrhage.

More recently, it was discovered that COX-2 inhibitors such as Celebrex increase the risk of heart attacks, and the Food and Drug Administration now considers “traditional” NSAIDs such as ibuprofen also capable of increasing heart attacks.

NSAIDs also can worsen heart failure and can cause kidney disease in susceptible people.

As to high blood pressure, many studies have found that NSAIDs increase blood pressure in people who already have hypertension.  In some cases, blood pressure is extremely difficult to control in the presence of NSAIDs.

Do NSAIDs interact with all antihypertensive drugs?

The answer is yes, but there may be some differences.

Angiotensin-converting enzyme inhibitors (ACE inhibitors), angiotensin II receptor blockers (ARBs) and diuretics appear to be particularly susceptible to the effects of NSAIDs.

Although some evidence suggests that calcium channel blockers (such as verapamil and diltiazem) are not affected as much as ACE inhibitors, ARBs and diuretics, people who use antihypertensives should assume that all blood pressure lowering drugs interact with NSAIDs.

To your good heath & longevity.

Ira Marxe
“The Good Health & Wellness Guy”

Copyrighted © 2009 – All Rights Reserved