5 ms·

>If taking aspirin were without side-effects and completely risk free, it might make sense for everyone with heart disease, or just worried about it, to take it

>If taking aspirin were without side-effects and completely risk free, it might make sense for everyone with heart disease, or just worried about it, to take it. But aspirin does have risks. Reducing blood's clotting potential can lead to hemorrhagic stroke (bleeding inside the brain). In the stomach, aspirin can cause everything from a feeling of mild heartburn to bleeding ulcers. Severe gastrointestinal bleeding can be deadly. https://www.health.harvard.edu/healthbeat/should-everyone-take-an-aspirin-a-day https://www.health.harvard.edu/healthbeat/should-everyone-ta...

bd 9y ago
It's ... complicated: "for every 1000 patients treated for a 5-year period, aspirin therapy would be expected to result in 1 excess hemorrhagic stroke compared with a benefit of ≈14 myocardial infarctions prevented in patients at moderate risk for CHD (5% to 10% 5-year risk)" http://stroke.ahajournals.org/content/36/8/1801 http://stroke.ahajournals.org/content/36/8/1801 "Aspirin has been found to be a safe in patients harboring cerebral aneurysms and clinical studies provide evidence that it may decrease the overall rate of rupture." https://www.ncbi.nlm.nih.gov/pubmed/25967073 https://www.ncbi.nlm.nih.gov/pubmed/25967073 "There was an approximately 40% increased risk of all gastrointestinal bleeding with low-dose aspirin in the observational studies reviewed here, a finding very similar to that reported in randomized trials" "The overall risk of intracranial hemorrhage was also increased by approximately 40% with long-term low-dose aspirin, which is also similar to the estimates from randomized trials, although an increase in risk was not consistently reported in all studies." https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4973997/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4973997/ "Aspirin reduced the 6 week risk of recurrent ischaemic stroke by about 60% and disabling or fatal ischaemic stroke by about 70%" https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5321490/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5321490/ "aspirin significantly reduced the risk of myocardial infarction among men by 43%" "significantly increased risk of major extracranial bleeding with aspirin [RR 1.54]. The excess risk of bleeds was mostly non-fatal. Perhaps by chance, fatal gastrointestinal (GI) or other fatal extracranial bleeds were lower in the aspirin group versus control [RR 0.48]" "In a meta-analysis of eight trials including 25,570 patients, aspirin use significantly reduced the overall incidence of cancer-related death by 21%" "In the meta-analysis of six trials, an increased risk of extracranial bleeding was observed with low-dose aspirin; however, the analysis of extracranial bleeding stratified by period of follow-up revealed that the risk of extracranial bleeding decreases over time, becoming comparable to that of placebo or no aspirin from 3 years onwards: <3 years" "In this same analysis, fewer cases of fatal bleeding were associated with aspirin use, compared with controls [OR 0.32]" https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4383813/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4383813/
MarkMc 9y ago
Even with the side effects and risks it might make sense for almost everyone who is aged 60 to take aspirin every day. There is now good evidence [1] that if 10,000 people aged 60 took aspirin for 20 years there would be: 174 fewer deaths from cancer and heart attacks 24 more deaths from strokes, ulcers and gastric bleeds So it seems that the benefits far outweigh the costs. [1] http://scienceblog.cancerresearchuk.org/2014/08/06/aspirin-and-cancer-not-quite-but-nearly/ http://scienceblog.cancerresearchuk.org/2014/08/06/aspirin-a...

bd 9y ago

It's ... complicated: "for every 1000 patients treated for a 5-year period, aspirin therapy would be expected to result in 1 excess hemorrhagic stroke compared with a benefit of ≈14 myocardial infarctions prevented in patients at moderate risk for CHD (5% to 10% 5-year risk)" http://stroke.ahajournals.org/content/36/8/1801 http://stroke.ahajournals.org/content/36/8/1801 "Aspirin has been found to be a safe in patients harboring cerebral aneurysms and clinical studies provide evidence that it may decrease the overall rate of rupture." https://www.ncbi.nlm.nih.gov/pubmed/25967073 https://www.ncbi.nlm.nih.gov/pubmed/25967073 "There was an approximately 40% increased risk of all gastrointestinal bleeding with low-dose aspirin in the observational studies reviewed here, a finding very similar to that reported in randomized trials" "The overall risk of intracranial hemorrhage was also increased by approximately 40% with long-term low-dose aspirin, which is also similar to the estimates from randomized trials, although an increase in risk was not consistently reported in all studies." https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4973997/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4973997/ "Aspirin reduced the 6 week risk of recurrent ischaemic stroke by about 60% and disabling or fatal ischaemic stroke by about 70%" https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5321490/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5321490/ "aspirin significantly reduced the risk of myocardial infarction among men by 43%" "significantly increased risk of major extracranial bleeding with aspirin [RR 1.54]. The excess risk of bleeds was mostly non-fatal. Perhaps by chance, fatal gastrointestinal (GI) or other fatal extracranial bleeds were lower in the aspirin group versus control [RR 0.48]" "In a meta-analysis of eight trials including 25,570 patients, aspirin use significantly reduced the overall incidence of cancer-related death by 21%" "In the meta-analysis of six trials, an increased risk of extracranial bleeding was observed with low-dose aspirin; however, the analysis of extracranial bleeding stratified by period of follow-up revealed that the risk of extracranial bleeding decreases over time, becoming comparable to that of placebo or no aspirin from 3 years onwards: <3 years" "In this same analysis, fewer cases of fatal bleeding were associated with aspirin use, compared with controls [OR 0.32]" https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4383813/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4383813/

MarkMc 9y ago

Even with the side effects and risks it might make sense for almost everyone who is aged 60 to take aspirin every day. There is now good evidence [1] that if 10,000 people aged 60 took aspirin for 20 years there would be: 174 fewer deaths from cancer and heart attacks 24 more deaths from strokes, ulcers and gastric bleeds So it seems that the benefits far outweigh the costs. [1] http://scienceblog.cancerresearchuk.org/2014/08/06/aspirin-and-cancer-not-quite-but-nearly/ http://scienceblog.cancerresearchuk.org/2014/08/06/aspirin-a...