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A large study published in the fall of 2018 has leaked a lot of ink in the newspapers, asking if the elderly should take a daily aspirin, which many consider a simple way to combat health problems important.
Taking a daily dose of aspirin has been touted as a way to reduce the risk of heart disease, cancer and possibly even dementia. And although factual research indicates that aspirin may have an effect on these problems, especially cardiovascular problems, two Topeka physicians said that everything depends on each patient and his medical history.
"A low-dose aspirin, as harmless as it sounds, I think a good person can cause a lot of problems," said Stormont Vail Health's cardiologist, Seshu Rao, adding that it was important for people to always consult a doctor before adding medication. to their daily diet.
The idea of taking a daily aspirin, often a low-dose baby aspirin, has long been popular. A study conducted in 2015 found that 47% of adults between the ages of 45 and 75 took a daily aspirin, even though they had no history of heart problems – the main condition for which this pill is inflicted.
Stormont family physician James McIntosh said the vast majority of his elderly patients were taking aspirin without consulting a health professional.
"I think we're at the point that it's almost like a vitamin or supplement," he said.
The recent study, published in the New England Journal of Medicine and led by Australian researchers, aimed to determine whether daily intake of aspirin was really the best medicine for about 19,000 healthy people over the age of 70 in Australia and the United States. The study found that taking aspirin daily had no benefit. In addition, there could be serious consequences.
Rao said that most people he saw in his cardiology office were taking aspirin every day and that it was an appropriate medication for someone with a history of cardiovascular problems. The key to the Australian study, he said, was that people were in good health.
"It's hard to hang his hat on a study," he said, adding, "Previously, nothing showed any significant benefit for aspirin as a stand-alone primary prevention. It's great for secondary prevention. "
This secondary prevention means that low doses of aspirin can be helpful not only with a history of cardiovascular disease, including high blood pressure and stroke, but also for people with diabetes, said Rao.
He and McIntosh said the key was to talk to your doctor because each situation depends on the patient's medical history.
"Any medicine should be taken with caution," said Rao. "As mild as aspirin may seem, you should talk to people who have had gastrointestinal bleeding – it's life threatening, even a low-dose aspirin, if you have no risk factor but you have a bad bowel or bad GI, can cause catastrophic bleeding. "
Aspirin, like other nonsteroidal anti-inflammatory drugs commonly referred to as NSAIDs, can cause gastrointestinal bleeding problems and other problems.
McIntosh, who ended his residency in 2017, said concerns about the excessive use of aspirin were a common topic at the medical school and among health professionals today. hui.
"This study (Australian) has somehow confirmed what we already suspected," he said, adding that since 2015 or 2016, the American College of Cardiology had guidelines against the use widespread aspirin because of the risk of bleeding.
McIntosh said that it was essential for doctors to "tease out" patients when they were discussing the medications that they were taking. Low dose aspirin has become so common that patients may forget to mention that they take it.
As a primary care physician, McIntosh said that he was not only concerned about the use of a daily aspirin, but also by the use of the drug. other NSAIDs such as ibuprofen, Aleve and others.
"Many people have aches and pains," he said. "I can not tell you how many of my older patients will say to me 'I take almost 400 mg of ibuprofen a day.' When you start combining these medications, you have aspirin. daily and other NSAIDs, before you know it, you have a high risk of bleeding. "
There are also dietary factors that can thin the blood, and adding all these problems increases the chances of serious problems, McIntosh said.
He encouraged patients to bring a list of their questions to the doctor, accompanied by a list of medications – over-the-counter and prescribed – of vitamins and any other product that they take regularly.
"The first thing I tell my patients, no matter what they take … is to talk to your doctor," he said. "Something that can be useful in some populations can be harmful for others."
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