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from the no-chewing-on-birch-bark,-either dept.
Widespread Aspirin use Despite Few Benefits, High Risks:
Aspirin use is widespread among groups at risk for harm including older adults and adults with peptic ulcers -- painful sores in the lining of the stomach that are prone to bleeding that affect about one in ten people. In a research report published today in Annals of Internal Medicine, researchers from Beth Israel Deaconess Medical Center (BIDMC) report on the extent to which Americans 40 years old and above use aspirin for primary prevention of cardiovascular disease.
"Although prior American Heart Association and American College of Cardiology guidelines recommended aspirin only in persons without elevated bleeding risk, the 2019 guidelines now explicitly recommend against aspirin use among those over the age of 70 who do not have existing heart disease or stroke," said senior author Christina C. Wee, MD, MPH, a general internist and researcher at BIDMC and Associate Professor of Medicine at Harvard Medical School. "Our findings suggest that a substantial portion of adults may be taking aspirin without their physician's advice and potentially without their knowledge."
[...] Concerningly, nearly half of adults 70 years and older without a history of heart disease or stroke reported taking aspirin daily. The authors noted that a history of peptic ulcer disease -- another contraindication for the routine use of aspirin -- was not significantly associated with lower aspirin use as one would have expected.
"Our findings show a tremendous need for health care practitioners to ask their patients about ongoing aspirin use and to advise them about the importance of balancing the benefits and harms, especially among older adults and those with prior peptic ulcer disease," said lead author Colin O'Brien, MD, a senior internal medicine resident at BIDMC and fellow at Harvard Medical School.
Journal Reference:
Colin W. O'Brien, Stephen P. Juraschek, Christina C. Wee. Prevalence of Aspirin Use for Primary Prevention of Cardiovascular Disease in the United States: Results From the 2017 National Health Interview Survey. Annals of Internal Medicine, 2019; DOI: 10.7326/M19-0953
So take one of these and call the doctor in the morning... but only if instructed to do so and there are no other contraindications.
(Score: 4, Interesting) by Mer on Tuesday July 23 2019, @10:20AM (9 children)
The risks involved with aspirin are real but also easy to understand. It does two potentially bad things: thin your blood being acidic.
Thinning your blood is important to keep in mind when you're injured or for women on their periods. Acidity is what causes stomach ulcers.
The numbers on the danger of aspirin come from taking too much aspirin. It's easy to raise your stomach acidity overboard. BUT, this problem is easily counteracted by taking some baking soda, the usual remedy for stomach acidity.
Meanwhile paracetamol and ibuprofen, unlike aspirin are hepatotoxic and are a load of your liver even during normal use, making them compete for liver work with a lot of other drugs. Sure they cause a lot less immediate injuries due to idiotic use, but two boxes of paracetamol (about 8g) can still kill you if you don't get medical attention.
Meanwhile, physicians are quick to tell you about the "numerous dangers of aspirin" (two is numerous I guess), and have told me in the past about taking baking soda "that's taking two drugs at once and should not be the initiative of a layman". I get them regularly adding paracetamol on my scripts even though I don't need it and insisting I make the switch. Aspirin is also kept behind the counter even though it's sold freely while paracetamol and ibuprofen are on the shelves.
And as an afterthought, aspirin does things other painkillers do not. Thinning the blood is useful reducing the blood pressure in case of headaches and helps the body shed heat faster in case of fever.
Shut up!, he explained.
(Score: 2) by EvilSS on Tuesday July 23 2019, @02:46PM (5 children)
Please explain how this works
(Score: 4, Informative) by All Your Lawn Are Belong To Us on Tuesday July 23 2019, @04:17PM (2 children)
It doesn't actually thin the blood, that is a misnomer. Thinning the blood would be a reduction in cells (most especially platelets for coagulation). Fewer particulates = less solid volume = more speed = lower pressure and faster heat conduction.
Aspirin does act upon the platelet surface, reducing the fibrous tendrils of the platelet and their ability to aggregate in the first phase, also called primary hemostasis. It makes platelets "slipperier" is the best description I've heard.
Aspirin helps relieve fever by action on prostaglandin enzymes (COX), not because it thins the blood.
Aspirin helps relieve headache primarily by similar action because the result of that is inflammation reduction, but not because it thins the blood.
The acidity of aspirin also acts upon the stomach environment and irritates the mucosal lining, which is why ibuprofen is generally recommended over aspirin if an anti-inflammatory is needed. (Ibuprofen can also irritate the stomach, but is far milder).
This sig for rent.
(Score: 2) by Azuma Hazuki on Tuesday July 23 2019, @09:43PM
It also, IIRC, has a slight but measurable effect on clotting; it likely donates its acetyl groups to the fibrin network before or during clot formation, resulting in thicker but fewer strands. I am at no risk of CVD, but did have an unprovoked blood clot in the lung once, and was advised to begin a daily aspirin regimen on the basis that it likely won't hurt anything (no one in my family has GI issues) and can only help.
I am "that girl" your mother warned you about...
(Score: 0) by Anonymous Coward on Tuesday July 23 2019, @10:30PM
Citric acid happens to be more acidic than acetylsalicylic one. *snigger*
Exercising some common sense is a truly necessary step before accepting any claims on faith. No matter the amount of sciencey verbiage sprinkled onto them.
(Score: 2) by All Your Lawn Are Belong To Us on Tuesday July 23 2019, @04:24PM (1 child)
Should have also said in the case of thinners, they also act on other stages of the coagulation process to reduce the blood's ability to coagulate. Less coagulation does also equal faster relative blood flow. But again, this isn't what aspirin does but rather what other agents like warfarin, coumadin, prasurgrel, and others.
This sig for rent.
(Score: 2) by EvilSS on Tuesday July 23 2019, @06:41PM
(Score: 2) by All Your Lawn Are Belong To Us on Tuesday July 23 2019, @04:21PM (1 child)
No, aspirin can be stomach irritating at normal doses.
Ibuprofen can affect the liver, but it is rare.
Acetaminophen (paracetamol) is far more likely to affect the liver, but unless you are elderly or already have hepatic problems up to 3g per day, ongoing, is generally considered safe.
And, as I just said in the other comment on your thread, aspirin does not "thin the blood", instead it acts on the existing platelets without reducing their numbers.
This sig for rent.
(Score: 0) by Anonymous Coward on Tuesday July 23 2019, @10:14PM
Which tells something about people doing the considering.
https://en.wikipedia.org/wiki/Paracetamol#Liver_damage [wikipedia.org]
(Score: 0) by Anonymous Coward on Wednesday July 24 2019, @08:47AM
The OP does not distinguish between three cases:
As an over 70 myself, I take ONE soluable baby (75mg) aspirin a day (very early in the morning). While this was
originally suggested by my doctor as reducing risk of stroke (by thinning blood and thus reducing pressure),
I find it reduces the aches I experience when first waking.
Myself and many others, take aspirin for pain relief for certain kinds of pain as pills (500mg) -
it reduces inflammation. I occasionally do this (two or three times a year) I might take paracetamol
or Ibuprophen instead, dependent on the type of pain.
Topical (ie as cream) - dosage not reproducible but probably under 100mg. Probably about twice a month.
These cases are completely different. - there is no way applying an aspirin based cream to my ankles
will affect my stomach, but it could be legitimately described as "regularly taking aspirin".
The "taking regularly! is generally means the first case - where the dose is very low - and people
with stomach pain should obviously not be doing this, but might be - probably with no ill effects.
Only taking the pain killer (500mg) dose is a danger to your stomach, and I doubt people with stomach
problems would do this regularly as someone taking pain killers probably wants to avoid pain!
I smell lies from big pharma.