How does aspirin work?

Hi I'm Sukhneja, I'm an interventional cardiologist working in central London. A common question that we often get asked is how does aspirin work? Well aspirin is something that was isolated over a hundred years ago from the willow bark and it's a medicine that we use to thin the blood. It doesn't actually make the blood thinner but what it does do is work on platelets which are a component of your blood. There's particular type of cells that clump together and form clots. Now in those patients who have heart disease or perhaps have had strokes you have narrowings of their arteries and therefore clots can be very dangerous in that situation. We often ask them to take blood-leaning medicines to reduce the likelihood of clots and aspirin is a medication that's effective in this situation. Now there are a number of other medications that we may ask those patients to take as well including clopidogrel, prazogrel or ticagrel. They all work together and we mustn't stop those medications unless you've spoken to your cardiologist about that. Aspirin is a relatively weak medication and typically is very safe to use however can cause bleeding problems particularly in older patients. Bruising of skin and if you knock yourself is very common. You may even get bleeding from the nose or from your gums. If this happens do speak to your doctor as they may need to identify the reason that you're having this bleeding trouble. For they may well be something that needs to be cauterized in the nose or gum disease may well need to be treated. Aspirin is generally a very safe medication but some patients with very severe asthma or particular allergies may well have reactions to it and therefore it's worth telling us about that if you've ever had a reaction to aspirin before. Most patients don't have a true allergy but there are those that do and they will need to be desensitized so we can continue to use the medication. In a more modern era we've now got some other strong blood thinning medications that can be used without aspirin and so in certain cases we may well consider giving you a medication like clopidogrel on its own or giving some more powerful blood thinning medications like rivaroxaban which is an anticoagulant instead of giving you aspirin. Aspirin is still used widely. The total number of patients who are using it has gone down because the guidance, clinical guidance for doctors has changed in recent times and so we only give it to those patients who we think will really gain value from it. Thanks for listening.