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11 Benefits and Side Effects of Aspirin (9 Contraindications To Be Noted)

Aspirin is one of the most widely used non-steroidal anti-inflammatory drugs in the world (the main component is acetylsalicylic acid), with about 120 billion capsules sold worldwide every year, and there is a large amount of clinical evidence that it has anti-inflammatory, analgesic, antipyretic, antiplatelet and other effects.

Where does aspirin come from?

Salicylic acid, the component of aspirin, is a polyphenolic compound in plants that regulates plant growth and protects against external threats.

This salicylic acid-rich plant has been used to treat diseases since ancient times, and its use dates back to 1500 BC, when the Egyptians used crude myrtle skin to treat rheumatism and back pain, and a thousand years later, Hippocrates used the bark and leaves of the willow tree to relieve pain.

It was not until the mid-19th century that salicylic acid was isolated from willow bark extract as the active ingredient, and then in August 1897, German scientist Hoffmann synthesized the first pure acetylsalicylic acid, which was sold and registered under the aspirin trademark in 1899.

Since then, aspirin has been widely used to treat fever, migraines and other conditions, including pain associated with inoperable cancer, rheumatoid arthritis, rheumatic fever and acute tonsillitis.

The main pharmacological mechanism of aspirin

The main pharmacological mechanism of aspirin is related to its non-selective inhibition of cyclooxygenase COX-1 and COX-2, which can inhibit the formation of prostaglandins and thromboxanes.

Prostaglandins have a wide range of biological functions, including cell proliferation and migration, angiogenesis, apoptosis, and inflammatory response.

What are the empirical benefits of aspirin?

1. Aspirin is beneficial for erectile dysfunction in men

Erectile dysfunction has significant negative effects on a man’s quality of life, including loss of self-esteem, avoidance of intimate behavior, anxiety and depression, which in turn can exacerbate sexual dysfunction and affect relationships between partners.

Since the interaction of psychology, endocrine, immunity and metabolism is the basis of its pathogenesis, erectile dysfunction is a multidimensional and complex pathological phenomenon. Considered independent risk factors for the development of metabolic syndrome, cardiovascular disease, and type 2 diabetes, with common underlying mediators.

A meta-analysis (2 randomized controlled trials involving 214 men with vascular erectile dysfunction) noted that the use of standard-dose aspirin significantly improved erectile function compared with placebo. Note 1

*Conclusion: For male vasogenic erectile dysfunction, aspirin may bring positive help, but limited by the small sample size, more studies are needed for further verification

2. Aspirin is beneficial for polycystic ovary syndrome-related infertility

Polycystic ovary syndrome is the most common endocrine disorder in women, with an overall prevalence of 5% to 15%, and is a common cause of infertility.

Currently, the diagnosis is based on the 2003 European Society of Human Reproduction and Embryology and the American Society for Reproductive Medicine, also known as the Rotterdam criteria.

Patients must meet 3 of the following 2 criteria (and exclude menstrual disorders and hyperandrogens of other etiologies):

1. Oferectulate/anovulation,

2. Clinical signs (hirsutism, acne, male pattern alopecia) or biochemical signs of hyperandrogenemia (increased serum testosterone levels), 3., polycystic ovaries, consisting of 12 or more follicles with a diameter of 2 to 9 mm or an increase in ovarian volume, more than 10 cubic centimeters

A systematic literature review and meta-analysis (10 randomized controlled trials, 948 PCOS patients) suggested that aspirin plus letrozole significantly increased endometrial thickness, cervical mucus score, ovulation rate, mature follicle count, pregnancy rate, and significantly reduced miscarriage rate compared with letrozole monotherapy. Note 1

*Conclusion: For polycystic ovary syndrome-related infertility, aspirin combined with letrozole may be of positive benefit, but further validation is needed due to the number and quality of included studies

3. Aspirin is beneficial for intracranial aneurysms

Cerebral aneurysms are abnormal dilations of the artery walls of blood vessels in the brain, with a 35:60 ratio of women to men between the ages of 3 and 2, and subarachnoid hemorrhage (SAH) is the most severe manifestation of ruptured intracranial aneurysm.

According to global statistics, about 3% of adults have unruptured intracranial aneurysm, small aneurysms (less than 7 mm) are usually not treated because patients do not benefit from existing treatments, and the risk of aneurysm rupture is not greater than the morbidity and mortality of these aneurysm treatment complications.

However, the continued growth of intracranial aneurysms can lead to subarachnoid haemorrhage (SAH), which has a mortality rate of 35% and can lead to some serious complications. Therefore, a non-invasive drug treatment is urgently needed to mitigate the risks.

A systematic literature review and meta-analysis (8 cohort and case-control studies with 10,518 participants) noted that oral aspirin was associated with a lower likelihood of growth of unruptured intracranial aneurysms and the risk of ruptured intracranial aneurysms. Note 1

*Conclusion: For unruptured intracranial aneurysms, aspirin use is associated with lower growth rates and risk of rupture

4. Aspirin reduces COVID-19 mortality

COVID-19 (Coronavirus Disease 2019) is an atypical pneumonia outbreak in December 2019 whose causative agent was isolated and named: severe acute respiratory syndrome coronavirus 12 (SARS-CoV-2).

COVID-19 can be spread through droplets and contact between people, susceptible to individuals over 50 years of age, the main symptoms are fever and cough, followed by myalgia, headache and fatigue, most infected people are mildly ill, but severe patients will worsen, develop various serious complications, and may even die.

A systematic literature review and meta-analysis (6 retrospective observational studies with 13,993 COVID-19 patients) noted that the use of low-dose aspirin (75 to 325 mg per day) during or before hospitalization was independently associated with reduced mortality. Note 1

*Conclusion: Low-dose aspirin may help reduce mortality for COVID-19, but further large, double-blind, placebo-controlled trials are needed to draw definitive conclusions due to possible risk of bias and confounding factors (risks and benefits should be weighed before giving aspirin to people with COVID-19).

5. Aspirin reduces the incidence of digestive tract cancer

Due to aging populations, population growth, smoking and obesity rates, Digestive tract cancers are common primary cancers, including: esophageal, stomach and colorectal cancers, ranking ninth, sixth and third among the most common cancers in the world, respectively.

While the diagnosis and treatment of digestive tract cancers has improved over the past few decades, long-term survival rates for patients remain low and tumor-related mortality rates remain high.

A systematic literature review and meta-analysis (including 113 observational studies) suggested that aspirin use reduced the risk of colorectal cancer, squamous cell esophageal cancer, esophageal and cardia adenocarcinoma, gastric cancer, hepatobiliary cancer, and pancreatic cancer, but not head and neck cancer. Note 1

These associations were consistent across sex, geographic region, and other covariates, with aspirin increasing with longer use for all gastrointestinal cancers (except head and neck cancer) and with increasing dose for colorectal cancer.

*Conclusion: Aspirin use is associated with a lower risk of gastrointestinal cancer, but more randomized controlled trials are needed

6. Aspirin prevents migraines

Migraine can be considered a chronic neurological disorder characterized by a recurrent onset of headache characterized by a moderate to severe headache with unilateral and pulsatile features that can be exacerbated by daily physical activity.

About 6% to 8% of men and 12% to 14% of women meet the diagnostic criteria for migraine. Untreated migraine attacks lasted quite long, from 4 hours to 3 days (median duration was 18 hours).

A systematic review (8 randomized clinical trials with 28,326 participants) noted that oral aspirin (at least 325 mg daily) reduced migraine frequency. Note 1

*Conclusion: Oral aspirin is a positive help in preventing migraine attacks, but more research is needed to confirm the optimal dose

7. Aspirin prevents cancer

Cancers are one of the most feared diseases to date, and surveys have found that some body tissues are millions of times more likely to get cancer than others, which was discovered more than a century ago.

The extreme differences in cancer incidence between different tissues are well known, and the lifetime risk of being diagnosed with cancer in individual body tissues is: lung 6.9%, thyroid gland 1.08%, brain and other nervous system 0.6%, pelvic bone 0.003%, laryngeal cartilage 0.00072%, esophagus 0.51%, large intestine 4.82%, small intestine 0.20%, stomach 0.86%.

A meta-analysis (16 randomized controlled trials, 104018 patients) noted that aspirin (daily doses ranging from 81 mg to 1200 mg, mean follow-up 5.48 years) was associated with cancer-related mortality, all-cause mortality (all-cause) compared with placebo or no aspirin Mortality) or a significant reduction in cancer incidence. Note 1

In addition, the same analysis also found that aspirin use was associated with an increased risk of bleeding, major bleeding, and gastrointestinal bleeding.

*Conclusion: To date, evidence suggests that oral aspirin is not significantly helpful in cancer prevention

8. Aspirin prevents cardiovascular disease

Cardiovascular disease is no longer just a problem in rich countries. In developing countries, it kills twice as many people as HIV, malaria and tuberculosis combined, and is characterized by narrowed or blocked blood supply to the vascular bed, most commonly due to atherosclerosis.

In the United States alone, an estimated 8260.<> million American adults, or about one-third, have one or more cardiovascular diseases.

A meta-analysis (9 RCTs with 102,621 participants) noted that aspirin use was associated with a reduction in major adverse cardiovascular events (up to 10% reduction, but no significant help in preventing myocardial infarction, stroke, ischaemic stroke, or all-cause mortality) at a mean follow-up of 6.9 years. Note 1

In addition, aspirin use increases the incidence of hemorrhagic stroke and major bleeding.

*Conclusion: For people without clinical cardiovascular disease, the current evidence provides modest support for the efficacy of aspirin (reducing major cardiovascular events by approximately 10%), but this benefit is offset by the risk of aspirin, so the risks and benefits should be carefully assessed by a healthcare professional before use

9. Aspirin improves cognitive function and prevents dementia

Mild cognitive impairment is a common disorder that accounts for 60-3% of adults over 5 and 75% of adults over 15, and is at high risk for dementia, especially Alzheimer’s disease.

The main feature is cognitive decline, which is a state between classic aging-related and dementia-consistent, and symptoms may be accompanied by a decline in other functions, such as attention, language, visual-spatial function, or executive function, in addition to memory loss.

A literature review and meta-analysis (8 studies with 36,196 participants without dementia or cognitive impairment) noted that taking low-dose aspirin (less than 300 mg daily) did not reduce the risk of cognitive decline and dementia, nor did it significantly help improve cognitive function scores. Note 3

*Conclusion: There is currently no evidence that low-dose aspirin delays cognitive decline or dementia, or improves cognitive test scores

10. Aspirin reduces the incidence of preeclampsia, also known as preeclampsia

Preeclampsia is the most common renal complication of pregnancy, characterized by high blood pressure, proteinuria, and edema, and usually develops in the last trimester of pregnancy.

Incidence varied across study populations, but generally accounted for between 3% and 7% of total pregnancy events and often occurred in women who became pregnant for the first time or became pregnant with twins.

A literature review and meta-analysis (10 randomized controlled trials, 3,168 participants) found that oral low-dose aspirin at 16 weeks’ gestation reduced the risk of early-onset (less than 37 weeks) preeclampsia by 65% compared with placebo or no treatment. Note 4

In addition, maternal aspirin intake helped reduce the incidence of adverse events associated with preeclampsia, including: hypertension during pregnancy, intrauterine growth retardation, fetal younger than gestational age, stillbirth, and neonatal weight.

*Conclusion: For people at high risk of preeclampsia, the use of low-dose aspirin can not only reduce the risk of morbidity, but also help reduce the associated adverse maternal and neonatal complications.

11. Aspirin for the prevention of acute respiratory distress syndrome/acute lung injury

Acute respiratory distress syndrome is a symptom of hypoxic respiratory failure characterized by severe impairment of gas exchange and respiratory function, leading to a drop in blood oxygen and even organ failure.

Acute respiratory distress syndrome often occurs in critically ill patients, with approximately 86.2 cases per 100,000 people, totaling about 200,000 cases per year in the United States, with a hospital mortality rate of 38.5%.

The most common causative agent is severe sepsis, which accounts for about 79% of cases, along with toxin inhalation, pulmonary contusion, acute pancreatitis, trauma, blood transfusion, burns, and postoperative cardiopulmonary bypass

A meta-analysis (6 clinical trials with 6562 patients at high risk of ARDS) noted that oral aspirin helped reduce the incidence of ARD/ARD by 29% (but not significantly on mortality). Note 5

The mechanism behind aspirin may be related to the reduction of intrapulmonary shunts, prevention of intrapulmonary shunts of hypertension, reduction of pulmonary edema and inflammatory response.

*Conclusion: Oral aspirin reduces morbidity but not mortality in people at high risk of developing acute respiratory distress syndrome

What are the side effects of aspirin?

Aspirin is a kind of drug, which means that there are still certain risks after use, and possible side effects include: stomach pain and heartburn (which can be reduced with meals), constipation, increased appetite, tremor, nervousness, irritability, urinary retention.

More serious side effects include: easy bruising/bleeding, severe bleeding from the stomach/intestines or other parts of the body, hearing impairment, tinnitus, kidney disease symptoms (such as changes in urine output), persistent or severe nausea/vomiting, unexplained fatigue, dizziness, black urine or stools, yellowing of the eyes or skin, sudden changes in vision, severe headache, slurred speech… Wait.

A small number of people may be allergic to this medicine, may have allergic reactions, symptoms include: rash / itching / swelling of the face/tongue/throat, severe dizziness, difficulty breathing, etc., if symptoms occur, please seek medical assistance immediately.

The above is not a complete list of side effects, please check with your doctor or pharmacist if you experience other uncomfortable symptoms.

Safety precautions

1. Do not start, stop or change the dosage of any medication without the approval of your doctor

2. If you take aspirin regularly, please do not stop the drug without authorization, it may have a rebound effect and increase the risk of blood clots or heart attack. Note 6

3. Do not combine with other anticoagulant drugs, which may increase the risk of serious bleeding complications, such as warfarin, apixaban, dabigatran (dabigatran etexilate), rivaroxaban

4. Do not combine with Heparin, Ibuprofen, Corticosteroids, Clopidogrel (platelet inhibitor drugs), antidepressants, may affect the drug efficacy

5. If taken in large doses or regularly, please do liver and kidney function tests and blood counts regularly to monitor progress or check side effects

6. Do not combine with the following health foods, which may increase the risk of bleeding, such as: bilberrycapsaicin, cat’s claw, danshen, evening primrose oilginkgoKavaomega-3 fatty acids

7. Stop taking it two weeks before surgery to avoid bleeding risk

8. Taking aspirin regularly and drinking alcohol increases the risk of stomach bleeding

9. A double-blind randomized placebo-controlled trial (4-week enrollment in 16,703 community-based older adults without cardiovascular disease, dementia, and physical disability, with a median age of 74 years) noted that aspirin (100 mg daily) did not reduce the risk of fracture but increased the risk of serious falls by 17%. Note 1

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