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BumRushDaShow

(128,939 posts)
Tue Oct 12, 2021, 11:14 AM Oct 2021

Aspirin Use to Prevent 1st Heart Attack or Stroke Should Be Curtailed, U.S. Panel Says

Source: New York Times

Doctors should no longer routinely begin prescribing a daily regimen of low-dose aspirin to most people at high risk of a first heart attack or stroke, according to new draft guidelines by a U.S. panel of experts. The proposed recommendation is based on mounting evidence that the risk of serious side effects far outweighs the benefit of what was once considered a remarkably cheap weapon in the fight against heart disease.The U.S. panel also plans to retreat from its 2016 recommendation to take baby aspirin for the prevention of colorectal cancer, guidance that was groundbreaking at the time. The panel said more recent data had raised questions about the putative benefits for cancer, and that more research was needed.

On the use of low-dose or baby aspirin, the recommendation by the U.S. Preventive Services Task Force would apply to people younger than 60 who were at high risk of heart disease and for whom a new daily regimen of the mild analgesic might have been a tool to prevent a first heart attack or stroke. The proposed guidelines would not apply to those already taking aspirin or those who have already had a heart attack. The U.S. task force also wants to strongly discourage anyone 60 and older from starting a low-dose aspirin regimen, citing concerns about the age-related heightened risk for life-threatening bleeding. The panel had previously recommended that people in their 60s who were at high risk for cardiovascular disease consult their doctors to make a decision. A low dose is 81 milligrams to 100 milligrams.

The task force proposals follow years of changes in advice by several leading medical organizations and federal agencies, some of which had already recommended limiting the use of low-dose aspirin as a preventive tool against heart disease and stroke. Aspirin inhibits the formation of blood clots that can block arteries, but studies have raised concerns that regular intake increases the risk of bleeding, especially in the digestive tract and the brain, dangers that increase with age. “There’s no longer a blanket statement that everybody who’s at increased risk for heart disease, even though they never had a heart attack, should be on aspirin,” said Dr. Chien-Wen Tseng, a member of the national task force who is the research director of family medicine and community health at the University of Hawaii. “We need to be smarter at matching primary prevention to the people who will benefit the most and have the least risk of harms.”

Research shows that the increased risk of bleeding occurs relatively quickly after someone begins regular use of aspirin. Those who are already taking baby aspirin should talk to their doctor. “We don’t recommend anyone stop without talking to a clinician, and definitely not if they have already had a heart attack or stroke,” she added. The task force includes 16 experts in disease prevention and evidence-based medicine who periodically evaluate screening tests and preventive treatments. Members are appointed by the director of the federal Agency for Healthcare Research and Quality, but the group is independent and its recommendations often help shape U.S. medical practice.

Read more: https://www.nytimes.com/2021/10/12/health/aspirin-heart-attack-stroke.html



This is a biggy... although I know a number of people have eschewed aspirin over the years due to gastrointestinal issues. We're running out of NSAIDs.
23 replies = new reply since forum marked as read
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Aspirin Use to Prevent 1st Heart Attack or Stroke Should Be Curtailed, U.S. Panel Says (Original Post) BumRushDaShow Oct 2021 OP
On a daily regimen of baby aspirin since my "episode" packman Oct 2021 #1
I've been on it since they replaced my aortic valve csziggy Oct 2021 #3
Still recovering from the aspirin news and some statins linked to Alzheimer's?? Good God y'all. Evolve Dammit Oct 2021 #10
One reason I haven't fought against use of low dose aspirin is family history csziggy Oct 2021 #11
Total cholesterol is high, but HDL is off chart. Heard conflicting info so I'm on atorvastatin. Evolve Dammit Oct 2021 #14
My cholesterol is at 126, HDL 53 csziggy Oct 2021 #15
That is amazing she lived to 97! My parents were 85 and 90 and I thought that was pretty good. Evolve Dammit Oct 2021 #16
Mom was pretty amazing overall csziggy Oct 2021 #17
Here's hoping for long lives for all of us! Evolve Dammit Oct 2021 #18
I'll drink to that! csziggy Oct 2021 #19
Cheers! Love your quote ("tagline?") I don't know what it's called.. Evolve Dammit Oct 2021 #20
It's a sig line (for signature) csziggy Oct 2021 #22
Thanks. I don't even have a "smart phone." Card-carrying Luddite! Evolve Dammit Oct 2021 #23
I hear you! Delphinus Oct 2021 #12
Lol. In 2015 the same "task force" recommended just the opposite JohnSJ Oct 2021 #2
Yeah I almost added BumRushDaShow Oct 2021 #5
You did right. For LBN what you see is what you get JohnSJ Oct 2021 #9
I much prefer lemons, fish oil, and EV olive oil bucolic_frolic Oct 2021 #4
Aspirin may protect against COVID-19, Israeli research finds womanofthehills Oct 2021 #6
My doc said the same when I asked ... don't do it. CousinIT Oct 2021 #7
I read once that the statistics on aspirin for heart attack was weaker than... Binkie The Clown Oct 2021 #8
Too bad the anti-vaxxers will use this to discredit science. pnwmom Oct 2021 #13
k and R riversedge Oct 2021 #21
 

packman

(16,296 posts)
1. On a daily regimen of baby aspirin since my "episode"
Tue Oct 12, 2021, 11:45 AM
Oct 2021

At my age and heart history, the doc said it was O.K. - but I did have a bleeding ulcer which almost did me in a while back. Just be careful and be alert to any changes, especially bowel movements if you are taking a daily aspirin.

csziggy

(34,136 posts)
3. I've been on it since they replaced my aortic valve
Tue Oct 12, 2021, 12:02 PM
Oct 2021

Fortunately no sign of bleeding other than hemorrhoids which have mostly been fixed.

But I am scheduled to talk to my cardiologist's PA in a couple of weeks. He prescribed Lipitor - two days before the newest study about a correlation between that category of statin and Alzheimer's. I did not take the Lipitor since, as I told him, I'd rather die of a heart attack than dementia.

Then he had me do a stress test - which showed no problems - and a lipid panel - with better than normal results (lipid panel tests cholesteral and all the different factors and is rated at normal, optimal or desirable; borderline high, and high. Every single factor for my test was lower than normal, which apparently is good. I don't see what Lipitor would do for me if those are the results without it!

But I will ask the PA if I can stop the aspirin, too. I hate taking unnecessary medications, especially if there are cautions that they might be contraindicated.

Evolve Dammit

(16,725 posts)
10. Still recovering from the aspirin news and some statins linked to Alzheimer's?? Good God y'all.
Tue Oct 12, 2021, 01:27 PM
Oct 2021

Doesn't sound like it was helping either. Aspirin was apparently giving me some GI issues, so I'm done.

csziggy

(34,136 posts)
11. One reason I haven't fought against use of low dose aspirin is family history
Tue Oct 12, 2021, 01:36 PM
Oct 2021

My father and my maternal grandmother both had blood clots that contributed to their deaths. I know I have a very strong clotting factor, so taking something that reduces the chance of clots is not a big problem for me.

As for the statins, I resisted before the Alzheimer's link came out - and so did my family doctor. My cholesterol stats have been good for all the years he has treated me and he doesn't think I need a statin. On the other hand, my sister who has very high cholesterol figures even with statins should be on them.

Evolve Dammit

(16,725 posts)
14. Total cholesterol is high, but HDL is off chart. Heard conflicting info so I'm on atorvastatin.
Tue Oct 12, 2021, 01:55 PM
Oct 2021
I never thought 81 mg aspirin was a big deal if you have some food with it? especially with family history. Mine all had strokes.

csziggy

(34,136 posts)
15. My cholesterol is at 126, HDL 53
Tue Oct 12, 2021, 02:08 PM
Oct 2021

They give the Cholesterol/HDL ratio at 2.36 with this:

Comments: ** RELATIVE RISK OF CORONARY HEART DISEASE ** TOTAL/HDL(MALE) TOTAL/HDL(FEM) RISK
3.43 / 3.27 -HALF AVERAGE
4.97 / 4.44 - AVERAGE
9.55 / 7.05 - 2X AVERAGE


As a female, I am well below their "half average" risk of coronary heart disease.

BTW, the aortic valve stenosis I had was probably hereditary. Mom had the same thing diagnosed at 86 and never had hers replaced. At the time she was diagnosed, open heart surgery was the only option and she never had an operation in her life so refused. When she died at 97 we think it may have been the heart since she died peacefully in her sleep. She also had severe dementia and metastatic liver cancer so we're glad her passing was quiet.

Evolve Dammit

(16,725 posts)
16. That is amazing she lived to 97! My parents were 85 and 90 and I thought that was pretty good.
Tue Oct 12, 2021, 05:53 PM
Oct 2021

never knew my grandparents; all died in their 50's. And they say the bad stuff skips a generation so I'm probably screwed!
With your Mom's issues, to pass in her sleep was a blessing. May we all be so fortunate. Best wishes.

csziggy

(34,136 posts)
17. Mom was pretty amazing overall
Tue Oct 12, 2021, 06:00 PM
Oct 2021

My BIL called her the Energizer Bunny because she never stopped - until Alzheimer's kicked her ass and took her brain from her.

Dad was 90 when he died, so I have some pretty good genes. I'm not sure I will live to my 90s - I've had too many injuries and too many operations - but my sister is like Mom and I'd bet she makes it to 100!

csziggy

(34,136 posts)
22. It's a sig line (for signature)
Wed Oct 13, 2021, 02:52 AM
Oct 2021

You may need a star to do it, but you can put pictures or quotes there, either from the My Profile or My Account link at the top right.

BumRushDaShow

(128,939 posts)
5. Yeah I almost added
Tue Oct 12, 2021, 12:15 PM
Oct 2021

"here we go... " to the OP but opted not to.

It's almost like the "OMG butter and eggs are bad for you and cause high cholesterol!!!11!!!!" later replaced with the "Oops... our bad... 'Vegetable shortening' is bad for you due to the trans-fats...".

I'm waiting for "oats" to be revoked.

It all continues to go back to the "all in moderation" thing.

bucolic_frolic

(43,156 posts)
4. I much prefer lemons, fish oil, and EV olive oil
Tue Oct 12, 2021, 12:13 PM
Oct 2021

in moderate amounts as part of my low-carb diet. What's important is what goes on in the liver. I'm not a doctor but I do watch YouTube.

womanofthehills

(8,703 posts)
6. Aspirin may protect against COVID-19, Israeli research finds
Tue Oct 12, 2021, 12:15 PM
Oct 2021
https://www.timesofisrael.com/aspirin-may-protect-against-covid-19-israeli-research-finds/. People who take small doses are 29% less likely than others to test positive, researchers say; those who do get COVID recover faster, and with reduced aftereffects

CousinIT

(9,241 posts)
7. My doc said the same when I asked ... don't do it.
Tue Oct 12, 2021, 12:21 PM
Oct 2021

He cited all of the above. And this was several years ago. Good to know he's up on this stuff.

Binkie The Clown

(7,911 posts)
8. I read once that the statistics on aspirin for heart attack was weaker than...
Tue Oct 12, 2021, 12:21 PM
Oct 2021

...the statistics on ESP and psychic phenomena, and we all know how flimsy that evidence is.

pnwmom

(108,977 posts)
13. Too bad the anti-vaxxers will use this to discredit science.
Tue Oct 12, 2021, 01:46 PM
Oct 2021

Science isn't some immutable truth, so scientists shouldn't be trusted at all -- they'll say.

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