Regular Aspirin Use Slows Worsening of Emphysema

Aspirin Use Reduces Rate of Emphysema Progression by More Than 50%

Background: Platelets are a type of blood cell made in the bone marrow. Their main purpose is to stop bleeding by clumping in blood vessels.
Smear shows platelets which can be inhibited by aspirin use

A blood smear viewed from a microscope. The blue dots are platelets, while the pink circles are red blood cells.

Activation of platelets contributes to inflammation in the body. This has been considered important in the development of COPD.  Aspirin inhibits or blocks the function of platelets.
Dr. Aaron is first author of study evaluating regular aspirin use and progression of emphysema

Carrie P. Aaron, M.D., Assistant Professor of Medicine at Columbia University Medical Center

Study: In the MESA Lung Study, Dr. Carrie Aaron and coauthors of Columbia University examined whether regular aspirin use might slow worsening (progression) of emphysema.  Either heart or lung CT scans were performed to determine the extent of emphysema in the lung at the start of the study and 10 years later. Subjects reported how often they took aspirin. Regular aspirin use was defined as 3 or more days per week.   The study was published online on December 12, 2017, in the journal CHEST doi: 10.1016/j.chest.2017.11.031. Results: There were 4,257 participants with average age of 61 years. 54% had smoked, and 22% used aspirin regularly. On average, the percent of emphysema increased by 0.6% over 10 years. Worsening (progression) of emphysema was slower among those who used aspirin regularly compared to non-aspirin users. The results were similar for 81 mg of aspirin (“baby aspirin”) and 325 mg (normal adult dose). However, there was no difference for changes in breathing tests (lung function) with regular aspirin use. Conclusion: The authors concluded that regular aspirin use was associated with more than 50% reduction in the rate of emphysema progression over 10 years. My Comments: Many individuals take aspirin for aches and pain, to reduce fever, and to reduce inflammation. At low doses, it is used to prevent:
  1. blood clots
  2. heart attacks by preventing clots from forming in blood vessels of the heart
  3. a stroke, but not to treat a stroke
  4. cancer of the colon
 The results of this study support the regular use of aspirin to slow worsening (progression) of emphysema. Unfortunately, aspirin had no effect on changes in breathing tests over the 10 years. You may wish to share the study findings with your health care professional. It is important to consider both benefits and risks of taking any medication, including low dose aspirin.

Donald A. Mahler, M.D. is Emeritus Professor of Medicine at Geisel School of Medicine at Dartmouth in Hanover, New Hampshire. He works as a pulmonary physician at Valley Regional Hospital in Claremont, NH, where he is Director of Respiratory Services.