// Is an Aspirin A Day A Good Idea?

Is an Aspirin A Day A Good Idea?

Fairleigh Dickinson University, April 4, 2019 –  For years, Americans have been told about the benefits of daily aspirin usage. Eighty-one milligrams of aspirin daily can be helpful in warding off a host of ailments in some patients, according to research. A quarter of all Americans use or have used aspirin on a daily basis at some point in their life due to a widespread campaign to promote its impact on heart health, over-the counter accessibility, and its perceived safety due to the name “baby aspirin.” 

The Fairleigh Dickinson University School of Pharmacy and Health Science’s National Health Survey finds 24 percent of adults nationwide are now or have taken baby aspirin on a daily basis. Among those who have not taken the pill daily, thirteen percent believe they will at some point in their lives. Most (81%) take aspirin at the recommendation of their doctor, and another 18 percent arrived at the decision without speaking with a health professional.

Over half of aspirin users take the pill for prevention purposes, as 56 percent do not report having a chronic disease or illness. Aspirin can be used as a primary prevention agent - to preclude disease(s) from occurring in the future, and a secondary prevention agent - to decrease risk of disease recurrence, in addition to other  usage indications. 

Polling data showed that those suffering from a chronic illness or disease were twice as likely than those without an illness to take baby aspirin (41% versus 18%). A racial divide exists in daily usage as well. A third (31%) of white respondents use the drug for primary prevention as compared with 14 percent of non-white respondents.  

Although daily baby aspirin usage can be used for a variety of reasons, the public believes heart protection is the primary reason. Seventy-eight percent reportedly take, have taken, or think they will take it at some point in their lives in order to help prevent heart disease. Another sixteen percent say taking baby aspirin is beneficial to one’s overall health. Even though the research indicates the drug can provide benefits in protecting against certain forms of cancer, only one percent say this is the reason they take or would consider taking the drug.

“In view of recent evidence published in the New England Journal of Medicine, as well as updated American College of Cardiology/American Heart Association Guidelines released on March 17, 2019, aspirin should not be used routinely for the primary prevention of cardiovascular disease. In many patients, the risk of bleeding may be similar or greater compared to the benefit of preventing a cardiovascular event,” said Dr. Anastasia Rivkin, Assistant Dean for Faculty and Professor of Pharmacy Practice at the FDU School of Pharmacy and Health Sciences. “Individual patient parameters, such as age, overall cardiovascular risk assessment, and other factors should be thoroughly discussed with the patient’s health care provider before considering aspirin to prevent heart disease.” 

“There is more data to support use of baby aspirin for colorectal cancer prevention than other types of cancer. The 2016 U.S. Preventive Services Task Force guidelines recommend low-dose aspirin to prevent colorectal cancer in patients who are also at risk for cardiovascular diseases and are not at increased risk for bleeding,” continued Rivkin. “Based on research, long-term aspirin use can result in up to a 40 percent reduction of colorectal cancer risk.  What we found in this survey is that the general public is not aware of aspirin benefits for cancer prevention.”

As with all drugs, complications can arise from daily baby aspirin use. The public has mixed views about the safety of baby aspirin, despite a fair degree of usage or planned usage. A quarter (27%) of Americans believe daily baby aspirin use only has health benefits, 40 percent believe it can also hurt someone’s overall health, while a third (32%) remain unsure.

“Eighty-one milligram baby aspirin has both benefits and risks associated with daily use. The assumption that aspirin only has health benefits is incorrect. One meta-analysis published in the Annals of Internal Medicine and the U.S. Preventive Services Task Force which showed daily or every other day baby aspirin use increased risk of major gastrointestinal bleeding and hemorrhagic stroke, especially with increasing age and among men. Before this medication is recommended to a patient, healthcare providers decide whether the primary prevention benefits outweigh the risk of bleeding. The answer to this question will vary widely from one patient to another,” noted Dr. ElifÖzdener, Assistant Professor of Pharmacy Practice. 

References for data: https://www.uspreventiveservicestaskforce.org/Page/Document/evidence-summary-bleeding-risks-with-aspirin-use/aspirin-to-prevent-cardiovascular-disease-and-cancer

Methodology –  The National Health Survey was conducted by The Fairleigh Dickinson University Poll on behalf of the FDU School of Pharmacy and Health Sciences. A random sample was drawn of adults nationwide, including in Alaska and Hawaii, and interviews were conducted on landlines and cellphones between January 28 - February 13, 2019. Respondents were screened in order to interview an adult, 18 or older. 

A total of 1000 interviews were administered by ReconMR in San Marcos, Texas. 296 interviews were conducted on landlines and 704 were conducted on cellphones by professionally trained interviewers using a CATI (Computer Assisted Telephone Interviewing) system. All interviews were conducted in English. Telephone numbers were purchased by ReconMR through Marketing Systems Group. 

Results for the total sample have a margin of sampling error of +/- 4.03 percentage points, including the design effect. 

Survey results are also subject to non-sampling error. This kind of error, which cannot be measured, arises from a number of factors including, but not limited to, non-response (eligible individuals refusing to be interviewed), question wording, the order in which questions are asked, and variations among interviewers. 

Weighting was applied to the sample to more accurately treat the respondents are representatives of the total population of the United States. 2019 estimates of the U.S. population by Claritas were used to weight the data. In this case, the proportions of three characteristics were used; Race, Age and Gender.  Each respondent falls into one, and only one, set and no respondent is left out.

For the second year, the FDU Poll received an “A” rating from statistician Nate Silver’s FiveThirtyEight blog. The ratings measure both accuracy and bias for all major polling services in the United States, providing an update to similar research the poll watchers conducted in 2014. FDU’s “A” rating puts it in the top 15 of the more than 380 polling institutes reviewed and graded from A+ through F. The FDU poll was found to have a 94 percent accuracy rate for predicting election results, and is one of only three A-rated polling institutes with zero bias to their rankings. 

Tables

Are you now, or have you ever, taken baby aspirin on a daily basis?

1 Yes     24% 

2 No     76% 

8 DK (vol)    0

9 Refused (vol)    0

Did a doctor recommend that you take a baby aspirin on a daily basis? [N = 238]

1 Yes     81% 

2 No     19% 

8 DK (vol)    0

9 Refused (vol)    0 

Do you think you will ever take baby aspirin on a daily basis? [N = 762] 

1 Yes     13%

2 No     80%

8 DK (vol)    7%  

9 Refused (vol)    1%

At what age did you begin taking baby aspirin on a daily basis? [At what age do you think you should begin taking baby aspirin?] [N = 300]

Average age   54

Which of the following health concerns best describes why you would take [would consider taking] baby aspirin on a daily basis? [N = 336]

1 Heart protection    78%

2 Cancer prevention   1%

3 Good for overall health   16%

8 DK (vol)    4%

9 Refused (vol)    1% 

To the best of your knowledge, does daily baby aspirin only enhance health, OR can baby aspirin also HURT someone’s overall health? 

1 Enhances health    28%    

2 Can hurt health    40%

8 DK (vol)    31%

9 Refused (vol)    1%

Question wording and order

ASP1 Are you now, or have you ever taken baby aspirin on a daily basis?

1 Yes  Ask ASP2

2 No  Ask ASP3

8 DK (vol) Ask ASP3

9 Refused (vol) Ask ASP3

ASP2 Did a doctor recommend that you take a baby aspirin on a daily basis?

1 Yes  Ask ASP4

2 No  Ask ASP4

8 DK (vol) Ask ASP4

9 Refused (vol) Ask ASP4

ASP3 Do you think you will ever take baby aspirin on a daily basis?

1 Yes  Ask ASP4

2 No  Ask ASP6

8 DK (vol) Ask ASP6

9 Refused (vol) Ask ASP6

ASP4 At what age did you begin taking baby aspirin on a daily basis? [At what age do you think you should begin taking baby aspirin?]

Enter age 

8 DK (vol) 

9 Refused (vol) 

ASP5 Which of the following health concerns best describes why you would take [would consider taking] baby aspirin on a daily basis? [rotate options]

1 Heart protection

2 Cancer prevention

3 Good for overall health

8 DK (vol

9 Refused (vol)

ASP6 To the best of your knowledge, does daily baby aspirin only enhance health, OR can baby aspirin also HURT someone’s overall health? [rotate options]

1 Enhances health

2 Can hurt health

8 DK (vol

9 Refused (vol)

Weighted Sample characteristics

1