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. Theres no longer a blanket statement that everybody whos 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 dont 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.
packman
(16,296 posts)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)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)Doesn't sound like it was helping either. Aspirin was apparently giving me some GI issues, so I'm done.
csziggy
(34,136 posts)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)csziggy
(34,136 posts)They give the Cholesterol/HDL ratio at 2.36 with this:
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)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)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!
Evolve Dammit
(16,725 posts)csziggy
(34,136 posts)Evolve Dammit
(16,725 posts)csziggy
(34,136 posts)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.
Evolve Dammit
(16,725 posts)Delphinus
(11,830 posts)Would rather die of a heart attack than Alzheimer's.
JohnSJ
(92,190 posts)Best advice, discuss your situation with you doctor who knows you
BumRushDaShow
(128,939 posts)"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.
JohnSJ
(92,190 posts)bucolic_frolic
(43,156 posts)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)CousinIT
(9,241 posts)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)...the statistics on ESP and psychic phenomena, and we all know how flimsy that evidence is.
pnwmom
(108,977 posts)Science isn't some immutable truth, so scientists shouldn't be trusted at all -- they'll say.