"Aspirin a day" therapy no longer recommended

[Darth Wong]

About time someone finally pierced this mythology.

http://www.cbc.ca/health/story/2009/05/ ... heart.html

Aspirin's risks outweigh benefits for healthy people
Last Updated: Thursday, May 28, 2009 | 6:29 PM ET
CBC News

Aspirin is generally recommended to prevent non-fatal heart attacks among people who have already had a heart attack or stroke.Aspirin is generally recommended to prevent non-fatal heart attacks among people who have already had a heart attack or stroke. (CBC)

Healthy people shouldn't take Aspirin to prevent heart disease, a new review suggests.

Aspirin and ASA are generally recommended to prevent non-fatal heart attacks among people who already had a heart attack or stroke. But the value of its long-term use by healthy people is uncertain, given the increased risk of internal bleeding.

Prof. Colin Baigent of the University of Oxford in London and his colleagues performed a review of studies documenting serious vascular events like heart attacks and strokes, and major bleeds in six trials involving 95,000 people at low to average risk, and 17,000 people at high risk.

Their findings appear in this week's issue of the medical journal The Lancet.

For primary prevention, Baigent and his colleagues found no significant difference in risk of serious vascular events (risk of serious vascular events dropped from 0.57 per cent to 0.51 per cent per year with the use of Aspirin), but the small risk of internal bleeds increased by about a third in those taking Aspirin (from 0.07 per cent to 0.10 per cent year).

Guidelines not justified

In the secondary prevention studies among people who had already had a stroke or heart attack and were at high risk for another, Aspirin reduced the risk of serious vascular events by about a fifth — a benefit that clearly outweighed any small extra risk of bleeding. That finding backs current guidelines for Aspirin's use.

"The currently available trial results could well help inform personally appropriate judgments by individuals about their own use of long-term Aspirin, they do not seem to justify general guidelines advocating the routine use of Aspirin in all healthy individuals above a moderate level of risk for coronary heart disease," the study's authors concluded.

There is no good evidence that the benefits of long-term use of Aspirin exceed the risks by an appropriate margin for tens of millions of healthy men and women of all ages worldwide who could potentially be affected, Baigent said.

Health Canada and the U.S. Food and Drug Administration say Aspirin is indicated for primary prevention to reduce the risk of a first non-fatal heart attack in people deemed at risk by their physicians, which the packaging also suggests.

In a commentary accompanying the review, Prof. Ale Algra and Dr. Jacoba Greving of the University Medical Centre in Utrecht, Netherlands, agreed that in most cases, Aspirin is not justified for primary prevention.

"Patients might not wish to be medicalised — such considerations are important in the decision to take Aspirin or not," the pair wrote.

They stressed the importance of making lifestyle changes such as quitting smoking, eating a healthy diet and getting regular exercise, in addition to considering drugs like Aspirin or cholesterol-lowering statins.

In short, it has known side-effects, and it only seems to help people who are in really bad shape, ie- people who have already had heart attacks. For healthy people, it's completely pointless to take an Aspirin a day.

I wonder if someone will do similar research on alcohol, to see if people with a healthy diet benefit from its supposedly therapeutic blood-thinner properties.

[Knife]

lol, anti oxidants, get it right. anyway, NSAIDS do their job right, just you don't necessarily need that job done. Does a number on your kidneys too. However, that said, no drug that I'm aware of is scott free on repercussions.

[SirNitram]

Holy shit! You mean filling your body with chemicals that cause blood to thin and thus make you a bleeder isn't entirely SAFE? EGADS.

I'll skip the horror stories of thirty minutes bleeding from a zit when I was still on blood thinners. Why? Because while it appeared I had clotting problems(Big one formed in my midsection, caused damage), I was genetically predisposed to bleed freely without clotting! And no one had checked, because it's rare to check such. And naturally, no one taking advice to do an aspirin regime was getting checked first.

[General Zod]

When the fuck did this "aspirin a day" bullshit start up? I've heard about "an apple a day" and "a multi-vitamin a day" but "an aspirin a day"? I always generally try and avoid any type of medication like that unless I absolutely have to take it, this sounds borderline insane.

[Broomstick]

Because it was useful in people who had had a heart attack, and because heart disease is a major killer in the US (among other countries), it became "fashionable" for awhile to put everyone over a certain age on asprin (or on even more potent blood thinners!) whether they had cardiac risk factors or not.

If you are still on the young side of life you may not have heard of it simply because you weren't near the demographic being told to take it.

[Justforfun000]

Actually a very simple way to thin your blood is to take garlic pills. The ones that Natural Factors has or in the States, Enzymatic therapy. They have a standardized form of Allicin.

I know from real life usage that it works quite well. I was taking 2 a day, (recommendation is only 1)...and my blood tests were showing that my blood was thin. She was a little confused and wanted to run more tests. I told her I was pretty certain it was the garlic and hold off. I stopped taking them, and bang. Back to normal. So maybe the one a day would be significant enough to be beneficial. Its even possible the level of thinning is still useful for some people that I got on the 2, but she was just confused why this came out of the blue when all prior tests showed no sign of it.

[His Divine Shadow]

I don't use aspirin once a day. But if I say have an headache, I'll go with the aspirin before going for the ibuprofen or paracetamol. I'm not sure anything is really accomplished with this or if ibuprofen or paracetamol are better to use than aspirin, it's just an impression I've formed over the years that aspirin is probably better to take if you got pain, rather than going straight to the "big guns" like ibuprofen. Anyone here got any concrete info on this it'd be appreciated.

[Tsyroc]

I don't use aspirin once a day. But if I say have an headache, I'll go with the aspirin before going for the ibuprofen or paracetamol. I'm not sure anything is really accomplished with this or if ibuprofen or paracetamol are better to use than aspirin, it's just an impression I've formed over the years that aspirin is probably better to take if you got pain, rather than going straight to the "big guns" like ibuprofen. Anyone here got any concrete info on this it'd be appreciated.

Aspirin has been around a lot longer so its safety when compared to other NSAIDs like Ibuprofen is bit more of a known quantity. In relation to paracetamol, aspirin actually does help reduce inflammation while paracetamol (acetaminophen aka Tylenol in the US) doesn't.

Personally, I think paracetamol works great for fevers and the associated pains but I prefer ibuprofen for other sorts of pain. Paracetamol is also a better choice if your have an upset stomach since NSAIDs are rather tough on your stomach. I would stay away from paracetamol for hangovers since it is processed in the liver as is alcohol.

I've read some articles that suggest that daily low dose aspirin might be good for your vascular system because it helps with inflammation which might contribute to hardening of the arteries. For the same reason it might also be helpful for people who have recurring, but not major, gallbladder issues.

[Shroom Man 777]

Funny story. My father's side is full of neurotic paranoid assholes (trait gets passed on, by the way) and so they like self-medicating themselves with all sorts of unprescribed stuff to protect themselves from death because they're a superstitious cowardly lot, and because they are really intelligent (not).

My uncle takes aspirin and then goes to the machine shop place where my dad has his slaves and his scrap. Uncle falls and for some reason, he lands on his balls. He hits his testicles.

Now, whereas this would just normally cause bruising, because he has taken aspirin the bleeding ends up becoming rather bad and so fluid (blood) ends up filling his scrotal sack.

His testicles swell to the size of an overripe mango.

We called an ambulance.

[Fingolfin_Noldor]

After watching a documentary on Aspartame, I have no idea what to eat or drink these days isn't going to be filled with some carcinogenic crap.

[mr friendly guy]

When the fuck did this "aspirin a day" bullshit start up? I've heard about "an apple a day" and "a multi-vitamin a day" but "an aspirin a day"? I always generally try and avoid any type of medication like that unless I absolutely have to take it, this sounds borderline insane.

Aspirin has been shown to reduce risk of subsequent strokes and heart attacks in those who already had them. It then became popular to prescribe them in older people (as these people are more likely to have the aforementioned diseases), even if they did not have a previous stroke or heart attack. The reasoning that we were preventing these diseases. However while there is some reasoning behind that line of thinking, ultimately the way to test it is with a big enough epidemiological study measuring cost vs benefits effects.

As the article states, if you haven't had a prior heart attack, you should only be prescribed aspirin as a primary prevention if you are in the high risk group.

[Ryan Thunder]

After watching a documentary on Aspartame, I have no idea what to eat or drink these days isn't going to be filled with some carcinogenic crap.

Aspartame doesn't cause cancer, if that's what you heard...

[Fingolfin_Noldor]

After watching a documentary on Aspartame, I have no idea what to eat or drink these days isn't going to be filled with some carcinogenic crap.

Aspartame doesn't cause cancer, if that's what you heard...

When the company that produced the tests happened to have been run by Donald Rumsfeld at one point of time, what should I think?

[Broomstick]

Re: Which painkiller to use.

For occasional use in normal adults it's sort of a toss-up. As mentioned, paracetamol/acetaminophen is easier on your stomach, but is bad to combine with alcohol. If you have inflammation or mild arthritis pain aspirin is better, but not if there is a problem with bleeding (either via injury or clotting disorder).

If you need to take OTC pain killers regularly first see a doctor about whatever is giving you a chronic problem. Then follow the doctor's advice.

[Knife]

I don't use aspirin once a day. But if I say have an headache, I'll go with the aspirin before going for the ibuprofen or paracetamol. I'm not sure anything is really accomplished with this or if ibuprofen or paracetamol are better to use than aspirin, it's just an impression I've formed over the years that aspirin is probably better to take if you got pain, rather than going straight to the "big guns" like ibuprofen. Anyone here got any concrete info on this it'd be appreciated.

Both Ibprofin and paracetamol stop prostaglandin production by the mast cells after degranulation. Prostaglandin acts like histamine, in that it initiates the inflammatory process, but has the added ability to stimulate a pain response to the presence of the prostaglandin. As to which to take, it's a toss up. Ibprofen is harsh on your nephrons and kidneys as a whole, while paracetamol is harsh on your liver. Aspirin? Couldn't tell you other than it is harsh on your stomache wall, as is the other drugs too.

[Broomstick]

All this talk of "harsh" - look, if you are a normal, healthy adult an occasional dose of any of the above is extremely unlikely to harm you in any way. If you have a liver/kidney/bleeding problem, or you must talk these things daily, THEN it becomes a problem.

[Justforfun000]

That's news to me about Ibuprofen being harsh on the kidneys...AND the bladder.

[Knife]

All this talk of "harsh" - look, if you are a normal, healthy adult an occasional dose of any of the above is extremely unlikely to harm you in any way. If you have a liver/kidney/bleeding problem, or you must talk these things daily, THEN it becomes a problem.

True, moderate use does little to you. However, there are people who pop a Vitamin I three or four times a day like a breath mint and it will after a few years or decade lead to serious problems. Occasional use is fine, but a large chunk of the population miss uses medication all the time, and simple NSAIDs are amongst them.

I, only having one kidney, don't take it at all. Well, when I was waiting for a root canal a couple months ago, the pain got to the point I was taking Ib profen a couple days, but other than that I haven't had that family of NSAIDs for years for minor over the counter aches and pains.

[Kar Kar]

After watching a documentary on Aspartame, I have no idea what to eat or drink these days isn't going to be filled with some carcinogenic crap.

Unless you're a an inhuman glutton and drinking three cases of diet pop a day for years on end you won't be suffering any ill effects.

Aspartame is probably one of the most thoroughly tested food additives because of the conspiracy horseshit surrounding it.

[Darth Wong]

I'm perplexed by the number of seemingly healthy people who take painkillers on a regular basis. It seems to me that they must get accustomed to popping these pills or something, and they can't handle the slightest discomfort without them after a while. I almost never take painkillers; in fact, I only take them when I have some kind of surgery.

[Justforfun000]

I only take painkillers if I'm in severe pain. Splitting headache will have me reaching for the Advil. If my back gets out of whack, which happens infrequently thankfully....I might try a couple of Tylenol 3's..o a perc if someone has one. Other then that, I just ignore it and let my body fix it.

[Havok]

I'm with Mike on this. Even when I crushed my feet with 1200lbs, I never took any pain killers. In fact, the only "painkiller" I've ever taken is Novocaine for when I was actually getting the splits in my heels stitched up (which after a few shots in each heel, the maximum allowed by law, still didn't work) and an ingrown toe nail ripped out when I was a kid.

I think that there is a large number of people that haven't experienced the real agonizing pain that some injuries cause and take pain killers for mild discomfort far more than they should. Probably a combination of people just not realizing what real pain can feel like and Doctors being a little too lax with prescriptions.

As to the OP, I'm with Nitram. Shocked that chemicals on a daily basis may be bad for you if there is nothing wrong.

[Shroom Man 777]

Of course. When doctors are given free trips to Dubai by pharmaceutical companies and go riding dune buggies in the desert while having medical conferences, why not prescribe a drug whose brand name you associate with Caribbean cruises and first-class flights?

Goddamn I love Big Pharma. Just look at it affect society and influence the way people treat their health. Now that is sapping and impurifying your precious bodily fluids!

[His Divine Shadow]

I think that there is a large number of people that haven't experienced the real agonizing pain that some injuries cause and take pain killers for mild discomfort far more than they should. Probably a combination of people just not realizing what real pain can feel like and Doctors being a little too lax with prescriptions.

I've felt such extreme pain I just wanted to die when I had an inflammation starting in my heart back in 2002, dragged out for hours, only relieved by popping more ibuprofen than was good for me and lying in bed, ended up with me being admitted to a hospital for a week on anti-inflammatory drugs and hooked up to an EKG machine 24/7. I still take an aspirin or maybe ibuprofen if I get a headache that doesn't go away in a few hours.

I've had my foot run over by a tractor and it had nothing on that btw.

[Broomstick]

Well, I admit to taking painkillers for menstrual cramps, but that's because I function much better at work when I'm not in pain and the alternatives - hot water bottles or heating pads - aren't accommodating to moving around. But that's 1 or 2 Tylenol in an entire day (actually, half the adult dose if you read the label) and only for 1 or 2 days a month. Likewise, if my arthritis is acting up I might take something for it, because it makes it easier to move around and it's moving around which is really what makes things better (for my sort of mild osteoarthritis, which I learned from medical professionals - other people with arthritis may have different requirements) but, again, that's maybe 1 pill in the morning and usually I won't need it again for months. Or, with my recent work making physical demands on my body that I haven't had in decades I did take something for muscle aches once or twice over the past year. And the occasional bad headache, again, once or twice in a year.

But really, those are all appropriate reasons, uses, and durations for OTC painkillers. I don't reach for pills at the first twinge, but neither do I see a reason to always tough it out particularly when it comes to working for a living. When I had surgery in the past I took the codeine for a couple days just after, mainly because it helped me sleep a hell of a lot better and that's good for healing (of course, codeine is not equally effective on all people - it works very well for me) but stopped entirely before I returned to work.

So... I guess I'm a (relatively) healthy person who does have a use for OTC painkillers. Does that help understanding for anyone? If you happen to have a higher than usual pain tolerance good for you but as I said I don't see any merit to unnecessary suffering.

Of course, part of the problem is that people take a dose of one of these painkillers, it's not enough, and instead of going to see a doctor they just take more and more of the stuff. If one or two pills don't help you then it's time to get professional help. And tell the doctor "Hey, I took Ibuprophen/aspirin/paracetemol/whatever [# of pills, # of days] and it didn't help/it's not getting better/the pain is still there" because that's an important fact for the doctor to consider.

In the US, the bullshit medical "system" we have accounts for some of that, but it doesn't explain why people in countries where cost is not a factor take too many OTC pills instead of seeking real help.

For some reason, though, different pain affects people differently. When I had my ribs broken I never had anything for the pain. When I sprained my knee and tore up the muscles I never needed anything more than Tylenol. But I'm completely intolerant to any sort of dental pain at all - which is one reason I'm so diligent about getting to the dentist every six months because prevention is soooooo much better than suffering. My Other Half, though, is remarkably tolerant of nearly all pain except stomach upset, which he finds absolutely debilitating even when minor (and then the poor man got pancreatitis, whose main symptom is excruciating, agonizing, oh-god-kill-me-now abdominal pain....) So some of you folks might have a very high tolerance for most pain, but there might be one or two things you really can't stand. In Mike's case I think it's stupid religious fanatics, but we don't have a pill for that (yet) so he makes do with SD.net.