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Aspirin. Cheap. Familiar. Should you take it?
This week, new prevention guidelines were released – with a focus on aspirin. SI has heard some confusion about this common medication – many people wondering what to do.
This made me think that it was time to give a brief overview of our position on aspirin.
In one form or another, this drug has been around for millennia. the Egyptians used the bark of a tree that contains some of the ingredients that are now in the pill of aspirin. The science behind aspirin is extraordinary – and it can calm inflammation, reduce pain and alleviate fevers. And they can inhibit the function of platelets, which contribute to blood clots.
From a few decades ago, researchers showed that aspirin could reduce the risk of heart disease – and the risk of death for people with a heart attack. The results for those who have a heart attack are particularly striking. Aspirin-based therapy reduced the risk of death by approximately 20% within 24 months of a heart attack. Aspirin rivaled our most potent coagulation medications for its ability to promote survival. And remarkably, this survival advantage has continued for years and years. I do not know of any expert who disputes this benefit – and our guidelines and textbooks still emphasize the importance of aspirin in the treatment of patients with heart attacks.
Aspirin also has benefits for people who have had stents – or undergoes a bypbad surgery. These studies also show that the benefits far outweigh the risks – and most people will want to opt for aspirin to reduce the risk of stent or bypbad graft failure – or failure. the formation of blood clots in the other arteries of the heart.
Note that the treatment with aspirin is not without risk. Aspirin inhibits platelets, which are components of the blood involved in coagulation. Although many people tolerate aspirin well, there is an increase risk of bleeding. Often, bleeding causes little problems and resorbs quickly – but sometimes bleeding can be life-threatening.
So where is the controversy over aspirin? The field of medicine where aspirin recommendations are undergoing major change is for people who have not shown signs of cardiovascular disease. The use of aspirin in this situation is called primary prevention – it is so called because it is intended to prevent the first case of heart disease.
The challenge of using drugs in primary prevention is that benefits tend to be lower than for people with established heart disease – and further into the future. Before being able to treat drugs for many years, drugs must be very effective and very safe, otherwise the balance of risks and benefits may not be very beneficial.
If you live in an area prone to earthquakes, then it would seem very interesting to invest in structures that can withstand the force of the Earth's motion. Despite the disadvantages, the cost and the aesthetics of such structures, people might want to. But for those who live in a region that has never experienced an earthquake – the risk is lower – and investment in such structures may seem less attractive – even though it is still possible that they have an earthquake . And borrowing money, for example, to reduce the risk that something will never happen, may not be worth it. Everything depends on the risk of the earthquake.
So here's what we know about aspirin for people who have not had heart disease. The studies are not all consistent, but they have a message. In one badysis of all the studies, the risks and benefits were quite close. Overall, about 250 people had to take aspirin for 10 years to prevent an adverse cardiac event. During this time, during this period, there was approximately one major bleeding episode for approximately 201 people treated (mainly intracranial and gastrointestinal). Overall, the increase in the number of major haemorrhagic events was slightly greater than the decrease in the number of cardiovascular events.
The American College of Cardiology and the American Heart Association released this week a new primary prevention document guidelines. & nbsp; For people not suffering from cardiovascular disease, they have demoted aspirin into a product that might be reasonable (but not recommended) & nbsp; for people aged 40 to 70 who is considered a treatment to avoid (potentially dangerous and should not be used). ) by persons over 70 years of age or at an increased risk of bleeding. In addition, Europeans had not already recommended aspirin for primary prevention. And for those who have other reasons to take aspirin, you should not confuse these recommendations with people without cardiovascular disease (including stroke) and those who have heart disease, cardiac procedures or other reasons to take aspirin. In any case, it is important to consult your doctor before stopping treatment.
In the end, it's up to you to decide on the use of aspirin for primary prevention. Aspirin is available over the counter – you can buy it easily. You should ideally make your choice based on your badessment of the balance of risks and benefits and how you feel about taking pills – this is an interesting topic for a patient-doctor discussion. The risks of studying may not apply exactly to you. What is clear is that, on average, the evidence of benefits is not as strong and we should not promote aspirin for primary prevention. For most people not showing signs of cardiovascular disease, there will be less – but the benefit of aspirin is simply not worth the risk and inconvenience – and this will be especially true for people over 70 years of age or at an increased risk of bleeding. And that fits perfectly with the current evidence – and now with the new guidelines.
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Aspirin. Cheap. Familiar. Should you take it?
This week, new prevention guidelines were released – with a focus on aspirin. SI has heard some confusion about this common medication – many people wondering what to do.
This made me think that it was time to give a brief overview of our position on aspirin.
In one form or another, this drug has been around for millennia. The Egyptians used the bark of a tree containing some of the ingredients contained in the aspirin pill. The science behind aspirin is extraordinary – and it can calm inflammation, reduce pain and alleviate fevers. And they can inhibit the function of platelets, which contribute to blood clots.
Researchers have shown for some decades that aspirin can reduce the risk of heart disease – and the risk of death for those who suffer a heart attack. The results for those who have a heart attack are particularly striking. Aspirin-based therapy reduced the risk of death by approximately 20% within 24 months of a heart attack. Aspirin rivaled our most potent coagulation medications for its ability to promote survival. And remarkably, this survival advantage has continued for years and years. I do not know of any expert who disputes this benefit – and our guidelines and manuals still emphasize the importance of aspirin in the treatment of patients with heart attacks.
It turns out that aspirin also has benefits for people who have had stents – or who have undergone bypbad surgery. These studies also show that the benefits far outweigh the risks – and most people will want to opt for aspirin to reduce the risk of stent or bypbad graft failure – or failure. the formation of blood clots in the other arteries of the heart.
Note that the treatment with aspirin is not without risk. Aspirin inhibits platelets, which are components of the blood involved in coagulation. Although many people tolerate aspirin well, the risk of bleeding increases. Often, bleeding causes little problems and resorbs quickly – but sometimes bleeding can be life-threatening.
So where is the controversy over aspirin? The field of medicine where aspirin recommendations are undergoing major change is for people who have not shown signs of cardiovascular disease. The use of aspirin in this situation is called primary prevention – it is so called because it is intended to prevent the first case of heart disease.
The challenge of using drugs in primary prevention is that benefits tend to be lower than for people with established heart disease – and further into the future. Before being able to treat drugs for many years, drugs must be very effective and very safe, otherwise the balance of risks and benefits may not be very beneficial.
If you live in an area prone to earthquakes, then it would seem very interesting to invest in structures that can withstand the force of the Earth's motion. Despite the disadvantages, the cost and the aesthetics of such structures, people might want to. But for those who live in a region that has never experienced an earthquake – the risk is lower – and investment in such structures may seem less attractive – even though it is still possible that they have an earthquake . And borrowing money, for example, to reduce the risk that something will never happen, may not be worth it. Everything depends on the risk of the earthquake.
So here's what we know about aspirin for people who have not had heart disease. The studies are not all consistent, but they have a message. In an badysis of all studies, the risks and benefits were quite close. Overall, about 250 people had to take aspirin for 10 years to prevent an adverse cardiac event. During this time, during this period, there was approximately one major bleeding episode for approximately 201 people treated (mainly intracranial and gastrointestinal). Overall, the increase in the number of major haemorrhagic events was slightly greater than the decrease in the number of cardiovascular events.
The American College of Cardiology and the American Heart Association have published this week new guidelines for primary prevention. For those who do not have cardiovascular disease, they have downgraded aspirin into a product that might be reasonable (but is not recommended) for people aged 40 to 70 and is considered as a product to avoid (potentially dangerous and not to be used) by the older ones. over age 70 or at increased risk of bleeding. In addition, Europeans had not already recommended aspirin for primary prevention. And for those who have other reasons to take aspirin, do not confuse these recommendations for people without cardiovascular disease (including stroke) for those who suffer from heart disease, dementia. Cardiac interventions or other reasons to take aspirin. In any case, it is important to consult your doctor before stopping treatment.
In the end, it's up to you to decide on the use of aspirin for primary prevention. Aspirin is available over the counter – you can buy it easily. You should ideally make your choice based on your badessment of the balance of risks and benefits and what you feel about taking pills – and that's an interesting topic for a patient-doctor discussion. The risks of studying may not apply exactly to you. What is clear is that, on average, the evidence of benefits is not as strong and we should not promote aspirin for primary prevention. For most people without cardiovascular disease, there will be less – but the benefit of aspirin is simply not worth the risk and inconvenience – and this will be especially true for older adults. 70 years of age or at an increased risk of bleeding. And that fits perfectly with the current evidence – and now with the new guidelines.
