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  1. #1
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    Daily Baby Aspirin: More harm than good?

    Healthy seniors taking baby Aspirin may be doing more harm than good
    CBC News
    September 17, 2018

    Large-scale study finds 'wonder drug' not working wonders

    In healthy elderly people who never had a heart attack, the widespread practice of taking a baby Aspirin every day may do more harm than good, according to a U.S.-Australian study of more than 19,000 volunteers.

    The trial has "provided convincing evidence that Aspirin is ineffective in preserving good health in elderly people without a medical [reason] to be using it," chief author Dr. John J. McNeil of Monash University in Melbourne told Reuters Health in an email.

    The results - which show that risks of major bleeding in low-dose Aspirin users overwhelm any heart benefits - were reported online in the New England Journal of Medicine and presented Sunday at the European Respiratory Society International Congress in Paris.

    The findings may upend a common practice.

    For people trying to prevent a second heart attack or stroke, evidence in support of baby Aspirin therapy remains strong. But the new study, known as ASPREE, looked at the long-standing question of whether a first heart attack, stroke, or case of heart failure could be prevented with small amounts of the blood thinner in Aspirin.

    Until now, the balance between risks and benefits in older individuals was unclear, said McNeil.

    Most volunteers had to be at least 70 years old. Patients who were black or Hispanic and living in the U.S. - two groups that face a higher risk of heart disease or dementia - could be age 65 or older. At the start of the study, all were expected to survive for at least five years.

    'Should set the record straight'
    After about five years of treatment, the rate of heart disease was not significantly lower in the 9,525 volunteers taking 100 mg of Aspirin daily than in the 9,589 who took placebo tablets.

    But the odds of a major bleeding episode were 38 per cent higher with aspirin. Problems like stroke and intestinal bleeding occurred in 8.6 per cent of Aspirin patients versus 6.2 per cent of placebo patients.

    "This should set the record straight," said Dr. Vincent Bufalino of the Advocate Heart Institute in Chicago, who was not involved in the study. "There's a lot of folks on both sides of this but this study should end the question. There is no benefit for seniors who do not have vascular disease."

    "I've spent the last five, six years trying to get all my seniors to stop taking Aspirin" based on the clear risks and unproven benefit, he told Reuters Health by phone. "If you look at the new findings, at best it's neutral and at worst it increases the bleeding risk."

    And what about people with high blood pressure or high cholesterol who might be taking other medicines to mitigate a higher risk of heart attack or stroke? In the new study, most volunteers fell into that category and Aspirin didn't seem to help them.

    "Essentially, we could not identify any subgroup in whom Aspirin was beneficial in preserving good health," Dr. McNeil said.

    The ASPREE study was stopped early as it became clear that the "wonder drug" wasn't working wonders.

    While there were 21.5 cases of death, dementia or disability per 1,000 patients each year in the Aspirin group, the rate was 21.2 with placebo. The difference wasn't statistically significant, meaning it could have been due to chance.

    But the rate of major bleeding with daily Aspirin use was 3.8 per cent, versus 2.8 per cent with placebo.
    When the McNeil team looked at death from any cause, Aspirin still made no difference statistically, with a rate of 12.7 per 1,000 patients each year with Aspirin and 11.1 with placebo.

    Extra cases of cancer were the chief reason for the higher death rate, with 3.1 per cent of Aspirin users dying of cancer versus 2.3 per cent in the control group.

    The higher pace of cancer deaths became apparent 3½ years after the study began, particularly death from stomach and intestinal tumours.

    The cancer finding surprised researchers because in other studies, Aspirin protected against death from cancer.

    Thus, the McNeil team said, the cancer results "should be interpreted with caution."

    The study was coordinated at 34 sites in the U.S. and 16 in Australia.

  2. #2
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    Re: Taking baby Aspirin may be doing more harm than good

    One day I asked my doctor if he was trying to kill me with certain meds he wanted me to try his answer was "if anything kills you it's the ASA that will".

  3. #3
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    Re: Taking baby Aspirin may be doing more harm than good

    The higher pace of cancer deaths became apparent 3½ years after the study began, particularly death from stomach and intestinal tumors.
    This is the part that worried me personally.

    My doctor said I should be doing the baby aspirin thing because of my peripheral vascular issues. But I'm going to stop at least until I see him on the 27th.

  4. #4
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    Re: Taking baby Aspirin may be doing more harm than good

    Please don't do that David! you'll increase the risk of a blood clot forming. 81mg ASA EC generic. Blood thinning is necessary when you have any type of vascular disease. Baby Aspirin is not to be taken on a daily basis.

    Screw the baby aspirin it's not enteric coated they just trying to promote chewing two tablets if you think you having a heart attack. Thins blood quicker. So in order to do that you have to buy and keep the brand name crap on hand. Sales pitch for brand mane Aspirin!

  5. #5
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    Re: Taking baby Aspirin may be doing more harm than good

    Actually, I take the Rexall generic.

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    Re: Taking baby Aspirin may be doing more harm than good

    Aspirin for primary prevention of cardiovascular disease, part 2
    by Deepak Bhatt, MD, MPH, Harvard Health Blog
    September 25, 2018

    Well, it seems as though not even a week can go by without more data on aspirin! I recently reviewed the ARRIVE trial and the implications for primary prevention - that is, trying to prevent heart attacks and strokes in otherwise healthy people. Since then, yet another large clinical trial - the ASPREE study - has come out questioning the use of aspirin in primary prevention. Three articles pertaining to this trial were published in the prestigious New England Journal of Medicine, which is an unusual degree of coverage for one trial and highlights its immediate relevance to clinical practice.

    Aspirin still strongly indicated for secondary prevention
    Nothing about any of the new aspirin data, including ASPREE, pertains to secondary prevention, which refers to use of aspirin in patients with established cardiovascular disease. Examples include a prior heart attack or certain types of stroke, previous stents or bypass surgery, and symptomatic angina or peripheral artery disease. In general, in patients with a history of these conditions, the benefits of aspirin in reducing cardiovascular problems outweigh the risks. Chief among these is a very small risk of bleeding in the brain, and a small risk of life-threatening bleeding from the stomach.

    ASPREE study suggests no benefit from aspirin in primary prevention
    ASPREE randomized 19,114 healthy people 70 or over (65 or over for African Americans and Hispanics) to receive either 100 milligrams of enteric-coated aspirin or placebo. After an average of almost five years, there was no significant difference in the rate of fatal coronary heart disease, heart attack, stroke, or hospitalization for heart failure. There was a significant 38% increase in major bleeding with aspirin, though the actual rates were low. The serious bleeding included bleeding into the head, which can lead to death or disability. Again, the actual rates were very low, but they are still a concern when thinking of the millions of patients to whom the ASPREE results apply.

    Rates of dementia were also examined, and again, there was no benefit of aspirin. Quite unexpectedly, there was a significantly higher rate of death in the patients taking aspirin. This had not been seen in prior primary prevention trials of aspirin, so this isolated finding needs to be viewed cautiously. Still, with no benefits, increased bleeding, and higher mortality, at least in this population of older healthy people, aspirin should no longer be routinely recommended.

    Another unexpected finding in ASPREE was a significantly higher rate of cancer-related death in the people randomized to aspirin. The prior thinking had been that aspirin might actually prevent colon cancer, though generally after many more years of being on aspirin. The ASPREE trial was terminated early due to lack of any apparent benefits. And even though five years is a relatively long period of follow-up, it may not have been long enough to find a benefit on cancer. Thus, the increase in cancer deaths may be a false finding. Nevertheless, the overall picture from this trial is not a compelling one for aspirin use for prevention of either cardiac or cancer deaths.

    Should healthy people take a daily aspirin?
    In general, the answer seems to be no - at least not without first consulting your physician. Despite being available over the counter and very inexpensive, aspirin can cause serious side effects, including bleeding. This risk goes up with age. So, even though it seems like a trivial decision, if you are healthy with no history of cardiovascular problems, don’t just start taking aspirin on your own.

    However, there are likely select healthy patients who have a very high risk of heart attack based on current smoking, family history of premature heart attacks, or very elevated cholesterol with intolerance to statins, for example, who might benefit. Therefore, the decision to start aspirin should involve a detailed discussion with your physician as part of an overall strategy to reduce cardiovascular risk. If you are already taking aspirin for primary prevention, it would be a good idea to meet with your physician and see if you might be better off stopping.

  7. #7
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    Re: Daily Baby Aspirin: More harm than good?

    Hope you noticed the part which relates to people with previous and existing vascular problems.

    you and I are stuck on it for life

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    Re: Daily Baby Aspirin: More harm than good?

    Chief among these is a very small risk of bleeding in the brain, and a small risk of life-threatening bleeding from the stomach.
    Study links low-dose aspirin to bleeding inside the skull - UPI.com
    May 13, 2019

    "It's much more important to optimize lifestyle habits and control blood pressure and cholesterol as opposed to recommending aspirin. Aspirin should be limited to people at the highest risk of cardiovascular disease and a very low risk of bleeding.""
    “Out beyond ideas of wrongdoing and rightdoing there is a field. I'll meet you there.” ~ Rumi

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    Re: Daily Baby Aspirin: More harm than good?

    On the positive side:

    Can Depression Be Treated With a Daily Baby Aspirin? | Psychiatry Behavioral Health Learning Network
    February 06, 2018

    I would not consider giving an anti-inflammatory agent to a depressed person without first measuring C-reactive protein (CRP), which is a good general marker for inflammatory status. For people with CRP levels above 5 mg/L, adding an anti-inflammatory may well help their depressive symptoms. This effect would perhaps extend down to a CRP level of 3 mg/L, although the data are not as strong for benefit at this level.


    Low-Dose Aspirin May Benefit the Brain | Fisher Center for Alzheimers Research Foundation

    An analysis of elderly Swedish women at high risk for cardiovascular disease found that regularly taking low-dose aspirin slowed decline in memory and thinking skills...

    Inflammation is increasingly implicated as a contributing factor to heart disease as well as Alzheimer’s, so it would make sense that an inflammation-fighter like aspirin may have benefits for the brain. In addition, aspirin thins the blood, which may help to prevent clots in blood vessels throughout the body, including the brain.


    Why Aspirin Is Incredible for Your Health - VICE
    Jan 4, 2017

    Randall Stafford, a professor of medicine at the Stanford School of Medicine, says the findings reinforce the ways that inflammation-fighting habits—from exercise to taking aspirin—could have a positive impact on a wide range of health problems. Inflammation and depression have a "complex relationship," Stafford adds. "Inflammation makes depression more likely, but depression itself may lead to unfavorable lifestyle changes that consequently increase inflammation." Aspirin can help break the cycle. In other words, it may encourage you to swim when you might otherwise sink.
    “Out beyond ideas of wrongdoing and rightdoing there is a field. I'll meet you there.” ~ Rumi

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