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posted by Fnord666 on Tuesday July 23 2019, @09:37AM   Printer-friendly
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.


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  • (Score: 2) by Azuma Hazuki on Tuesday July 23 2019, @09:46PM

    by Azuma Hazuki (5086) on Tuesday July 23 2019, @09:46PM (#870476) Journal

    NSAIDs other than aspirin all carry a risk of GI bleeds and cardiovascular disease. They inhibit cyclooxygenase isoforms 1 and 2 by interfering with arachidonic acid metabolism, but aspirin is the only one whose COX-1 inhibition is irreversible, IIRC; the net effect is that prostaglandin synthesis is reduced in all NSAID therapy scenarios, but aspirin also causes an increase in prostacyclins.

    The risk varies across the drug type; IIRC indomethacin is one of the worst, while naproxen is supposedly one of the least dangerous, enough that it's sold OTC.

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