7 ms·

> It seems like despite a lack of evidence, it would be very hard to ethically approve a randomised trial of teeth brushing over a long period. This is the exa

by abtinf 8y ago

> It seems like despite a lack of evidence, it would be very hard to ethically approve a randomised trial of teeth brushing over a long period. This is the exact same argument that was used to evade studying the effects of low doses of aspirin on heart disease. Everyone “knew” it worked, so it was thought to be unethical to put people at risk of heart disease into a control group. Many millions of people spent money for years to consume a constant supply of aspirin. When the question was finally studied, it all turned out to be nonsense. In fact, it turned out to increase death rates from higher cancer risk. All that money could have been spent on actually improving health. https://utswmed.org/medblog/aspirin-heart-disease/ https://utswmed.org/medblog/aspirin-heart-disease/

hn_throwaway_99 8y ago
> When the question was finally studied, it all turned out to be nonsense. That's certainly not the conclusion I came to at all from the article you linked. The main takeaway I got was that daily aspirin may not be warranted if you're not at high risk of heart disease (one reason earlier studies showed more conclusive benefits of aspirin is there were more smokers, i.e. more high risk people, back then). So yes, it makes sense to look at risk/benefits for individual patients rather than "all old people get aspirin", but the idea that aspirin can protect against heart attacks is not nonsense.
whycombagator 8y ago
I am pretty sure that low dose aspirin has some benefits for some people/conditions. At least I remember reading studies that suggest as much. So naturally I was curious about it being “nonsense” for heart disease. A quick skim of the article + a quick search shows it’s not as clear cut and conclusive as you suggest. Interestingly, neither is the increased risk of cancer discussed in the article. Aspirin has been shown to have the opposite effect too. I found it hard to glean what dosages where used in the studies mentioned in the article but the couple I saw were 100mgs per day. I didn’t see mention of if they were enteric coated or taken with meals. In the US baby aspirin is 81mg and in the UK there are 75mg available. Both are enteric coated. In Australia it seems 100mg might be considered low dose and widely available. It would be interesting to see more studies on this topic using lower dose, coated, aspirin taken with a meal. The US/UK low dose aspirin are 19-25% lower than at least a couple of dosages the studies mentioned. Those lower dosages may help mitigate bleeding risk. Seeing as some of aspirins effects are longer lasting, perhaps alternative dosing schedules could also be looked at (every other day etc.) - this may further help mitigate the bleeding risk whilst still providing benefit.
- Scoundreller 8y ago
  The doses were different for legal reasons. Aspirin for children is unnecessarily risky in most cases but different countries set different cutoffs for restricted doses vs. unrestricted adult doses. But ya, dosing is underrated. Something that's bad at X dose may be beneficial at 1/Yth the dose.
  - deleted 8y ago
    [deleted]

by abtinf 8y ago

hn_throwaway_99 8y ago

> When the question was finally studied, it all turned out to be nonsense. That's certainly not the conclusion I came to at all from the article you linked. The main takeaway I got was that daily aspirin may not be warranted if you're not at high risk of heart disease (one reason earlier studies showed more conclusive benefits of aspirin is there were more smokers, i.e. more high risk people, back then). So yes, it makes sense to look at risk/benefits for individual patients rather than "all old people get aspirin", but the idea that aspirin can protect against heart attacks is not nonsense.

whycombagator 8y ago

I am pretty sure that low dose aspirin has some benefits for some people/conditions. At least I remember reading studies that suggest as much. So naturally I was curious about it being “nonsense” for heart disease. A quick skim of the article + a quick search shows it’s not as clear cut and conclusive as you suggest. Interestingly, neither is the increased risk of cancer discussed in the article. Aspirin has been shown to have the opposite effect too. I found it hard to glean what dosages where used in the studies mentioned in the article but the couple I saw were 100mgs per day. I didn’t see mention of if they were enteric coated or taken with meals. In the US baby aspirin is 81mg and in the UK there are 75mg available. Both are enteric coated. In Australia it seems 100mg might be considered low dose and widely available. It would be interesting to see more studies on this topic using lower dose, coated, aspirin taken with a meal. The US/UK low dose aspirin are 19-25% lower than at least a couple of dosages the studies mentioned. Those lower dosages may help mitigate bleeding risk. Seeing as some of aspirins effects are longer lasting, perhaps alternative dosing schedules could also be looked at (every other day etc.) - this may further help mitigate the bleeding risk whilst still providing benefit.

Scoundreller 8y ago
The doses were different for legal reasons. Aspirin for children is unnecessarily risky in most cases but different countries set different cutoffs for restricted doses vs. unrestricted adult doses. But ya, dosing is underrated. Something that's bad at X dose may be beneficial at 1/Yth the dose.
- deleted 8y ago
  [deleted]