Aspirin as an anti-aging drug

aspirin as an anti-aging drug

In my book, Stop the Clock: The Optimal Anti-Aging Strategy, I discussed how aspirin has the potential to be a true anti-aging drug. But I also emphasized that aspirin comes with the risk of major bleeding, and that most doctors would likely recommend against taking it, unless one had had a previous heart attack.

But aspirin is readily available over-the-counter and is cheap, and lots of people have heard about its ability to prevent heart attacks, so many of them are taking it anyway. There’s also a large body of data on aspirin, because starting several decades ago, doctors began recommending it for primary prevention of heart attacks; millions of people have taken aspirin for many years.

Primary and secondary prevention of heart attacks

Let’s start with the basics. Primary prevention refers to the prevention of heart attacks or other cardiovascular events in someone who has never previously had such an event. The person may be considered to be high risk, meaning that signs and symptoms of cardiovascular disease (CVD) exist, signs such as blocked arteries, or symptoms such as angina pectoralis (chest pain). Current recommendations are that aspirin should not be used for primary prevention, since risks may outweigh benefits, but millions of people are doing so anyway.

Secondary prevention refers to those who have already had a previous cardiovascular event; doctors may or may not recommend aspirin in secondary prevention, depending on the patient.

Why the difference in recommendations? Because aspirin can cause major, possibly fatal, bleeding.

Aspirin and major bleeding

Long-term daily use of low-dose aspirin, approximately 80 mg a day, is associated with about a 50% relative increase of major bleeding events compared to those taking no aspirin.(1) The absolute rate of bleeding – and we’ll see why this is important – was 5.6 bleeding incidents per 1000 person-years for aspirin, and 3.6 without aspirin. Major bleeding includes gastrointestinal bleeding and intracerebral hemorrhage, both of which are medical emergencies.

According to my calculations, you would need to take daily low-dose aspirin for 180 years to expect to experience one major bleeding event. Obviously that will vary depending on a number of individual factors; also, experiencing a major bleeding event would be extraordinarily bad, and the averages would be little consolation.

It’s useful to add that, “irrespective of aspirin use, diabetes was independently associated with an increased risk of major bleeding episodes” of about 36% – compare to aspirin use risk of about 50%. (From same reference as above.)

A major review (meta-analysis) of aspirin studies concluded that it is “of uncertain net value” in primary prevention because the risk of bleeding may outweigh the reduction in coronary events; there’s a better risk/benefit ratio for secondary prevention.

Aspirin prevents cancer

So, I’m sure you’re asking, if risks outweigh or equal the benefits in prevention of heart attacks, why are we discussing aspirin use? Because aspirin prevents cancer too, and this must be added to the risk/benefit ratio to determine the true utility for health of aspirin use.

A meta-analysis led by Peter Rothwell found that long-term, low-dose aspirin users had more than 20% lower risk of dying from cancer.(2) Reduction in risk of gastrointestinal cancers was more than 50% (hazard ratio 0.46).

Aspirin also reduces the risk of cancer metastasis by more than one third.(3)

In contrast, in primary prevention of heart attacks, while there’s a small reduction in coronary events, the death rate due to vascular causes is no different between aspirin users and non-users.

Therefore it seems that aspirin works far better at cancer prevention than at heart attack prevention.

According to the American Cancer Society, a man’s lifetime risk of developing any cancer is about 43%, and his risk of dying from cancer is about 23%.

According to the Rothwell analysis, the absolute reduction in cancer deaths from taking aspirin over a 20 year period is about 7%. Therefore if you take aspirin for that long, your risk of death from cancer may drop from from 23% to 16%. Many other factors are involved here, however; for instance, lung cancer is still one of the major causes of cancer death, and not smoking cigarettes reduces that risk to next to nothing.

Let’s say you take aspirin over the next 20 years, and you don’t smoke, thus taking lung cancer risk, at about 7% lifetime, out of the equation. Without aspirin, your risk of dying from cancer may be on the order of 16%. (This is lifetime risk, and I’m assuming that you are older, not say in your twenties or thirties.) With aspirin, your risk of cancer death may drop to about 9%. Meanwhile, your risk of a major bleeding event over that 20 years is about 10%.

But, even if you don’t take aspirin, you have a risk of major bleeding over 20 years of about 7% (3.6 x 20/1000). So your absolute risk of major bleeding with aspirin is only 3% more over 20 years (relative risk more like 50% greater).

Meanwhile, you’ve just about cut your risk of death from cancer in half. Aspirin also has efficacy against heart disease, stroke, and possibly dementia. (Rothwell et al. found that aspirin lowers risk of cancer by 20%; the difference here, where I’m saying 50%, is due to a 20-year timeline, and not smoking.)

I haven’t been able to find how many people die from episodes of major bleeding, but it does not make the top ten. Heart disease is the leading cause of death, and cancer is the second, and aspirin has efficacy in preventing both. It’s also important to keep in mind one’s relative risk for any of these diseases; for instance, a man in his twenties has a low risk of heart disease and cancer, and taking aspirin would likely have a risk/benefit ratio much more skewed toward risk than benefit. A man in his sixties (like me) likely has a much more favorable risk/benefit ratio, since his risk of heart disease and cancer is much higher, while the risk of bleeding is not nearly as increased.

Peter Rothwell, the neurologist who had led many of the most recent studies, has said, “It does look like a good bet for men over 50. When you add the cancer benefits to the vascular benefits, it looks more compelling.” He takes it himself.

How does aspirin work?

Most of the speculation on the mechanism of aspirin on cancer has focused on inflammation, which aspirin reduces, or platetets, which aspirin inactivates.

While these could very well be at work, there’s another possible mechanism, which is lowering of body iron stores. The ability of aspirin to cause bleeding may turn out to be both a bug and a feature. Most of the iron in the body is contained in red blood cells, and bleeding lowers these levels. In turn, high iron levels are linked to many diseases and perhaps even to aging itself.

Low-dose aspirin is 80 mg a day, while one adult size aspirin tablet is 325 mg. Risk of major bleeding rises considerably with dose, and a higher dose of aspirin has not been shown to be more effective in prevention of cancer and heart attacks than low-dose.

Conclusion: aspirin as an anti-aging drug

Aspirin is cheap, over-the-counter, and could be one of the strongest disease prevention and life-extending interventions available, but it is not without risks. Recommendations on aspirin seems to have gone through two phases, and are entering a third: first recommended to prevent heart attacks; then, when it was discovered that primary prevention and bleeding risks cancelled out each other, it was recommended only for some people who were at high risk for a (or another) heart attack; now, this is changing again, since it’s been discovered that aspirin helps to prevent cancer – and if iron-lowering is the mechanism, possibly many other diseases as well.

Should you take low-dose aspirin? Ask your doctor. (Please see our disclaimer.)

Check out our Supplements Buying Guide for Men.



Leave a Comment:

Hutton says November 20, 2015

Hey Mangan: I know you are always in pursuit of new information. Have you ever come across The Peoples Chemist site? His research corroborates many of your suggested practices but he disagrees on the aspirin subject. Either way, you may find the site interesting. I found it researching the cheapest way to remove fluoride from water.

    P. D. Mangan says November 20, 2015

    Haven’t heard of them before, thanks. Site looks like it must be minting money.

      Joseph O'Brien says May 24, 2016

      Holy Shit!!! The People’s Chemist is selling whey for $40/Lbs.

Tuba says November 22, 2015

For me the question is not “does Aspirin help?” because it can but rather what’s the down side if one also is taking something like ginkgo or nattokinase?

    P. D. Mangan says November 22, 2015

    Tuba, I don’t know about gingko, but nattokinase added to aspirin would likely increase the risk of bleeding without a compensatory increase in benefit. I wouldn’t do that.

Tuba says November 23, 2015

Then I would take nattokinase over aspirin as there are other ways to reduce iron without sacrificing blood slipperiness. And given my druthers, I would prefer a bleed over a clot. It is interesting that you have not discussed the possible interaction of vitamin E and aspirin in that E can increase bleeding as well.

Tuba says December 2, 2015

Well… 23&Me says I have the genes that gives me a two in three of having macular degeneration. Aspirin has been at least implicated in “wet” macular degeneration. And when I do take aspirin it has to be coated or it destroys my stomach. So I will skip regular aspirin use.

Aspirin Dramatically Cuts Prostate Cancer Risk - Rogue Health and Fitness says October 8, 2016

[…] underrated and cheapest life-extension drug currently available. It increases lifespan in mice and prevents heart attacks and cancer. A new study in the International Journal of Cancer reports that aspirin dramatically cuts prostate […]

Ben Gunn says October 8, 2016

My grandmother, (died 1981) took 2 regular aspirins before bed for many years. She lived to be 91 and in good health, climbing a long staircase every night to get to bed. She died overnight from a hemorrage. Not a bad deal really, quick. High blood pressure, she had no other disease, just wore out.

Rick Duker says January 28, 2017

Thanks for all the great information on your site.

I’m curious if it is safer to take White Willow Bark extract which provides 75mg of salicin pet capsule. Would that provide the same benefits as aspirin?

I’m 54 and have high blood pressure. Can aspirin help with that?

    P. D. Mangan says January 28, 2017

    My understanding is that aspirin was invented precisely because salicylate causes some literal gut-wrenching. I don’t know if salicin does that. However, willow bark extract was recently found to be the strongest life-extension substance ever. (In animals.) I doubt if aspirin would do much if anything for hypertension. Most important for good blood pressure are good body weight, good insulin sensitivity, and no excessive drinking of alcohol.

Bill says February 19, 2017

Dennis, It was your Dumping Iron which brought me to this site.Good book by the way ! But I was looking for information about anemia and your book came up on the search.

Why was I looking ? Well one day out walking I had chest pains and got really tired quickly..Not good feeling at all.
The GP took blood tests and discovered I was anemic..And his first thought was bleeding in the gut and maybe colon cancer. Stool tests showed occult bleeding in the gut..Big panic ! Bookings for colonoscopy etc all in a hurry and expensive..

But I was also taking aspirin as part of my own program to prevent colon cancer and I knew it could cause bleeding as well. So I suggested I stop the aspirin and then retest.

And the subsequent stool tests showed no bleeding. So this is a real problem for some of us when we take aspirin..Getting anemic is no fun..So now I am looking for something that is cheap & over the counter which works like aspirin but does not cause bleeding..

    P. D. Mangan says February 20, 2017

    Thanks, Bill. Being anemic is definitely bad news and, just as you say, doctors suspect bleeding, especially in men. The downside of aspirin got to you.

    Rick Duker says February 20, 2017

    You may want to try White Willow Bark extract as an alternative to Aspirin. It contains salicin which your body converts to salicylic acid. I have used it without side effects.

      Bill says February 20, 2017

      Thanks Rick..I will search it out and give it a try.

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