Yesterday I blogged that aspirin may become more popular now that the NSAIDs have been linked with heart disease and stroke. Today, an article in USA Today also endorses aspirin:
"We will look back and say we spent the 1980s and 1990s abandoning aspirin in droves," Avorn says. "And now we find out that, well, aspirin is well-established to prevent heart attacks."
Physicians will need to reaquaint themselves on the use of aspirin for pain. I have personally not advised/prescribed aspirin above the cardioprotective dose of 325 mg/day for several years. I do not know the usual therapeutic or the maximum dose of aspirin for pain. I have some learning to do.
I do believe that physicians need to be cautious with the prescription of aspirin. Its adverse GI side effects- including gastrointestinal bleeding- are well known. On the plus side, Aspirin is well know to reduce cardiovascular mortality at doses of 81-325 mg/day. It has been studied for the prevention of strokes at doses up to 650 mg twice a day. But what about aspirin at higher doses?? Is it possible that aspirin at higher doses could increase cardiovascular mortality?
In addition, Aspirin has some nasty side effects in overdose situations (including accidental overdose in the elderly) including acidosis and tinnitus (ringing in the ears).