Donald Trump has said he takes a higher than recommended daily dose of aspirin because he wants “thin blood” to protect his heart.
In a lengthy interview about his health with The Wall Street Journal, Trump, 79, said he is in “perfect health”, partly putting it down to his use of aspirin.
Aspirin can be used in a preventive manner like this – but it is generally taken as a lower dose, sometimes called a “baby aspirin”.
Trump’s high dose risks doing more harm than good, by causing stomach ulcers and brain bleeds, experts have warned.
So, how do the risks and benefits of daily aspirin stack up – and how could Trump’s unorthodox regime be affecting his health?
Aspirin might usually be thought of as a pain killer and anti-inflammatory medicine, but also helps prevent heart attacks and strokes.
It does this by reducing blood clotting, as most heart attacks and strokes are caused by a blood clot blocking a blood vessel to either the heart or the brain. The anti-clotting effect was discovered in the 1950s, partly because of prolonged bleeding in people using aspirin chewing gum after getting their tonsils out.
In the 1980s, daily aspirin was commonly taken by older people to cut their risks of heart attacks, at a dose of 325 milligrams or one standard tablet – the same dose that Trump said he uses in the new interview with The Wall Street Journal. The dose for pain relief is usually one or two of the standard tablets.
Re-evaluating aspirin benefits
In the past few decades, doctors have become more cautious about preventive aspirin. In the 1990s, trials showed that a lower dose of about 80 mg gave the same cut in heart attacks and strokes with less bleeding.
“If we’re using a drug for prevention, we want to use the minimum dose that gives the benefit without increasing the side effects,” said Professor Beverley Hunt, head of the charity Thrombosis UK.
The risks from aspirin are not minor. In the stomach, aspirin irritates the lining, leading to stomach ulcers. It can also cause minor bleeds elsewhere in the gut, which can lead to anaemia and fatigue in older people.
Aspirin may also lead to bleeds in the brain if someone bangs their head. “If you’re on aspirin and you hit your head and you have an intracranial bleed, it will be bigger on aspirin,” said Professor Hunt.
Donald Trump’s hands have been bruised at times (Photo: Bloomberg/Getty Images)People on aspirin are also more prone to bruises, which happen if a knock causes minor bleeding under the skin.
Trump has been seen with bruises on his hands, which he said in the interview was caused by taking aspirin. His solution is to put make-up on the bruises, he said.
Trump’s aides said there had been several incidents where he had cut his hands, including once when Pam Bondi, now his attorney journal, nicked him with her ring when doing a high five, the newspaper reported.
Despite the the change in medical practice, Trump said in the interview he prefers to stay on the high dose because that is what he has been taking for 25 years. “I’m a little superstitious. They say aspirin is good for thinning out the blood, and I don’t want thick blood pouring through my heart,” Trump said. “I want nice, thin blood pouring through my heart.”
Aspirin works by blocking blood clot formation (Photo: Artur Plawgo/Science Photo LIbrary/ Getty Images)Another controversial aspect of the treatment is whether he should be taking aspirin at all. In the UK, doctors generally recommend it only for people who have already had a heart attack or stroke, because they are at high risk of having a further one.
In people who have never had a heart attack or stroke and don’t have any other heart conditions, aspirin use was recommended against by a medical guidelines body called Nice in 2009. “We are sort of moving away from it,” said Professor Hunt.
In America, guidelines recommend against starting preventive aspirin for people who haven’t had a heart attack or stroke who are 60 or over, because older people have a higher bleeding risk.
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This is not the only time Trump has disregarded medical orthodoxy. In 2020, the president said he was taking an anti-malaria drug called hydroxychloroquine to prevent Covid.
At the time there was little evidence this would be effective, and trials later showed it didn’t work. But Trump’s endorsement helped spur widespread use of the medicine, which at high doses can cause heart problems.
Professor Hunt said the public should not follow Trump’s lead on aspirin use. “Do not take it regularly unless there is a clear medical indication agreed with your doctor – and definitely not the higher dose.”
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