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Aspirin Use to Prevent Cardiovascular Disease and Colorectal Cancer: Preventive Medication

by Michael Johnson

| Updated May 16, 2024 |
The CRC and CVD are the number two oldest of NCDs in these two aforementioned categories of diseases in many parts of the world. The study reveals that the people with CRC have a 2-4 times greater risk of developing CVD than those who do not have CRC.

USPSTF panel recommends screening and monitoring adults aged 40-59 years with an increased risk of cardiovascular disease being as high as 10% within the next 10 years by performing a low-dose aspirin regimen in order to prevent cardiovascular diseases and colorectal cancer.

Being clear on the therapeutic versus the possible adverse outcomes of aspirin use is of fundamental importance for a person’s decisive position on aspirin consumption.

According to the latest research, the potential benefits of aspirin for this group of age are almost non-existent. The population considered are the ones who have a low risk of bleeding and are willing to take low-dose aspirin immediately after the procedure, but not immediately for those who are likely to derive most of the benefits.

However, the same task force counsels against the use of low-dose aspirin for cardiovascular disease (CVD) primary prevention in adults who are 60 years or older.
Aspirin Use to Prevent Cardiovascular Disease image
Photo credit: iStock/dszc

Cardiovascular Disease Prevention

Cardiovascular disease (CVD) still remains one of the diseases that has spread through several regions of the world. It is certainly not an exaggeration in regarding it as one of the leading factors for chronic disability and death in people. The circulatory system which is typically made up of the arteries, the heart, capillaries and veins, is affected by this condition.

Types of Cardiovascular Disease

Let’s take a brief look at four of the main types of CVD below;

Coronary heart disease

This heart disease happens as a result of when the flow of oxygen-rich blood to the heart muscle is blocked or decreased.

As a result, the heart suffers since it is mostly overworked. This condition might cause heart attacks, angina (chest pain due to the lack of blood flowing to the heart muscle) or it may lead to heart failure, which occurs when the heart is unable to pump blood in the whole body.

Strokes and TIAs

A stroke is an instance when the blood flow to a particular section of the brain is restricted, this then results in brain damage and in some cases, death. The TIA is the same as the stroke however it fades after the blood flow to the brain is blocked. Some of the symptoms of a stroke or TIA can be shortened as FAST, which stands for:
F- Face drooping,
A- Arm weakness, or
S- Speech difficulties. The person may not be able to lift both arms or speak.
And finally the letter T which represents time. It means you should dial the emergency number 999 if all the previous symptoms listed above are present.

Peripheral arterial disease

This occurs when the arteries that are connected to the limbs, most especially the legs, are blocked suddenly.

This may lead to:
Dull or cramping leg pain that worsens during walking and improves with the individual takes a rest.
Hair loss on the legs and feet.
Numbness or weakness in the legs
Chronic ulcers (open sores) on the legs and feet.

Aortic disease

The aorta can be affected by a group of diseases, including a condition that is often critical and known as aortic disease. Blood flows from people's hearts to the rest of their bodies through this huge blood tube.

Aortic aneurysm, as one of the aorta’s most prevalent diseases, requires particular attention. This marks the point when the aorta that a part of it bulges outward because of the pressure.

In most cases there are no symptoms of this disease, but it could burst the blood vessels and start to bleed, which can be fatal.

Role of aspirin in preventing cardiovascular disease

Aspirin works by reducing the risks of blood clots so that they can not form in any damaged arteries and hence prevent heart functions from failing. People who have suffered any form of a cardiovascular disease usually take an aspirin to help mitigate the risks involved every day. Aspirin could be prescribed to those patients who are in danger of having the first symptoms of a heart attack. Aspirin prevents clots, hence blocking the first heart attack.
Role of aspirin in preventing cardiovascular disease image
Photo from Nature

Colorectal Cancer Prevention

Colorectal cancer is a global health problem, which has proliferated into thousands of new cases, simultaneously increasing the rate of mortality. In 2023, medical data revealed that 8 million people were diagnosed with this deadly cancer and about 881,000 people died from it. These statistics place emphasis on the importance of creating awareness, early detection, and new treatment methods to fight this fatal disease.

The mortality rate annually is about 600,000 and that is why it is important to detect, and treat CRC early. Aspirin could be the single most studied drug in respect to how it can be used in a much wider context as a chemopreventive treatment in reducing the world's incidence of colorectal cancer.

Role of aspirin in preventing colorectal cancer

Aspirin has mixed results in the number and size of adenomatous polyps, greater development of which is associated with progressing to tumors borderline and malignancies. Precisely, it is still unclear what the mechanism of aspirin is - with regard to primary or recurrent CRC prevention.

It has long been a mystery, but recent studies have shown that taking aspirin at least daily for two years can decrease the risk of colorectal cancer and the risk of death after a diagnosis of colorectal cancer. The reduction of the risk starts at 10 to 20 years after they began to take aspirin.

USPSTF Recommendation

USPSTF made an evidence-based moderate-certainty assessment that taking aspirin daily among persons ages 40 up to 59 of 10% or higher risk of having cardiovascular disease during the next 10 years would be beneficial for them due to the fact of its modest benefit in preventing them from developing cardiovascular diseases.

The risk-benefit ratio for primary cardiovascular disease prevention using aspirin in people over 60 years of age is consistent risk-benefit.

Benefits and Harms of Aspirin Use

Research has shown that low dosage of aspirin daily doesn’t actually increase the risk of bleeding among quadragenarian for people older and who have no history of cardiovascular disease. For the aged people who stand a higher risk of cardiovascular disease, moderate use of aspirin reduces the chances of non-lethal heart attacks and strokes, and with the advent of aspirin for cardiovascular risk-prone conditions, prolonged usage has proven to be quite advantageous. So, starting early in life with undoubtedly accrue lifetime benefits.

Although the use of daily aspirin may appear to be advantageous, it may not be without its risks. Statistics prove that the risk of hemorrhagic stroke, cerebral bleeding, and bleeding in the gastrointestinal tract is higher in those who take aspirin. Adults who are above 60 years of age are most likely to bear those risk factors mentioned.
Aspirin Use image
Photo from LinkedIn

Who Should Take Aspirin?

Having considered all the possible advantages and disadvantages, you should discuss with your primary healthcare practitioner whether to use aspirin for primary prevention.
Some specialists consider, as a general rule, that:

The advantages and disadvantages of using daily low-dose aspirin for primary prevention are probably well balanced for the majority of individuals.
In those over 70, the chance of bleeding might exceed the advantages.
Aspirin should not be used for primary prevention by anybody under 50.

It is quite necessary that you inquire from your doctor before you try to use aspirin to combat cancer or heart attack, to know if it will increase your chances of bleeding or if cardiovascular disease is a cause for concern given your health condition or age.

Conclusion

The taking of low-dose aspirin to prevent cardiovascular disease and colorectal cancer should be based on the individual risk factors and age. To be clear about it, these medicines have their side effects as slight bleeding is more likely in aged people. To have an idea of the pros and cons of aspirin taking, it should be discussed with professional healthcare workers so that an informed decision can be made.

Reference

U.S. Preventive Services Task Force. (2022). Final update summary: Aspirin Use to Prevent Cardiovascular Disease: Preventive Medication. Retrieved from

Chen Zhang, Yunjiu Cheng, Dongling Luo, Jinghua Wang, Jianhua Liu, Yujun Luo et al. Association between cardiovascular risk factors and colorectal cancer: A systematic review and meta-analysis of prospective cohort studies. “eClinical Medicine Journal”, March 18,2021.

Cardiovascular disease” NHS Uk Conditions 2022.

Frederick A Spencer MD and Gordon Guyatt, MD “Aspirin in the primary prevention of cardiovascular disease and cancer (Beyond the Basics)”, 26 December 2023.

Jin J. Use of Aspirin to Prevent Cardiovascular Disease. JAMA. 2022;327(16):1624. doi:10.1001/jama.2022.5564

National Cancer Institute, “Colorectal Cancer Prevention” October 25, 2023.


Article by
Michael Johnson
I am Dr. Michael Johnson. I am dedicated to providing the best medical care to my patients. In my spare time, I enjoy sharing medical knowledge with a broader audience. Writing has become a major hobby of mine, allowing me to express my passion for medicine. I particularly enjoy writing health-related articles, aiming to provide readers with practical medical advice and information. Through my writing, I hope to help more people understand how to stay healthy, prevent diseases, and better understand medical knowledge.

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