Video: Aspirin Linked to Internal Bleeding

Daily, low-dose aspirin may not be the heart-healthy choice for everyone

bottle of aspirin

Does an aspirin a day keep the heart doctor away?

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Low-dose aspirin therapy has long been touted as a way to reduce your risk for heart trouble. But a new Italian study finds that for some people, the benefits of using low-dose aspirin may be outweighed by an increased risk of bleeding in the stomach and the brain.


Stanley Hazen, MD, a cardiologist at the Cleveland Clinic Heart & Vascular Institute, did not take part in the study but says the debate mostly concerns low-risk subjects who have no known history of coronary artery disease. In these people, doctors question whether or not the benefits of aspirin outweigh the risks.

In the study, researchers looked at the link between low-dose aspirin and the risk for bleeding among nearly 400,000 people, including diabetics. About half of these people were prescribed low-dose aspirin of 300 milligrams or less each day and then matched with someone who did not take aspirin during the five-year study period.

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Results showed that, among non-diabetics, the use of aspirin was associated with a 55 percent increased risk of gastrointestinal bleeding and 54 percent increased risk of bleeding in the brain.

Diabetics, on the other hand, had a much lower risk of major bleeding episodes, regardless of whether they used aspirin or not.

“Having elevated blood sugar can directly modify the protein on the platelet’s surface and alter its function, so platelet function is thought to be decreased among people with diabetes. Also, the platelet life span is shorter, so that would also increase platelet turnover and can influence the effect that aspirin has,” Dr. Hazen says.

Researchers concluded that any benefit of low-dose aspirin therapy may be offset by the risk of major bleeding – except for diabetics. However, more studies are needed.

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Dr. Hazen says some people are a bigger bleeding risk than others, but if you’re concerned about your aspirin therapy, you should talk to your doctor.

“People with an increased risk for having a complication from aspirin include those who are advanced in age or who have a prior history of GI bleeding or other bleeding problems – particularly if they have had problems associated with aspirin use. These are the people that we need to be particularly careful when starting aspirin, particularly if they’re a low cardiac risk.”

Complete findings for this study are in the Journal of the American Medical Association.

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