Revisiting Who Should Take Aspirin

The Skeptical Cardiologist weighs in on the aspirin debate.
Thank you Dr. Pearson.

The Skeptical Cardiologist

Four years ago the skeptical cardiologist wrote the (in his extremely humble  and biased opinion) the definitive post on aspirin and cardiovascular disease.  Entitled “Should I take aspirin to prevent stroke or heart attack“,  it pointed out that although Dr. Oz had recently told almost all middle-aged women to take a baby aspirin and fish oil, there was, in fact no evidence to support that practice.

The publication of the ASPREE (Aspirin in Reducing Events in the Elderly) trial results in the latest issue of the New England Journal of Medicine further strengthens the points I made in 2014.

Between 2010 and 2014 the ASPREE investigators enrolled over 19,000 community-dwelling persons in Australia and the United States who were 70 years of age or older (or ≥65 years of age among blacks and Hispanics in the United States) and did not have cardiovascular disease, dementia, or disability.

(It’s important…

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Daily low-dose aspirin found to have no effect on healthy life span in older people

In the total study population, treatment with 100 mg of low-dose aspirin per day did not affect survival free of dementia or disability. Among the people randomly assigned to take aspirin, 90.3 percent remained alive at the end of the treatment without persistent physical disability or dementia, compared with 90.5 percent of those taking a placebo. Rates of physical disability were similar, and rates of dementia were almost identical in both groups.

For the full NIH news release click here.

iMedicalApps: Aspirin Guide – Medpage Today

Makes sense of USPSTF recommendations

Source: iMedicalApps: Aspirin Guide | Medpage Today

Loyal readers know I’ve been looking at this daily aspirin thing for quite some time.  Read this, or this, and this.  So when I learned about a new iPhone app I had to download it and enter my personal data.

The app says I should take low dose aspirin daily.  I stopped taking aspirin a few years ago after a minor bleeding episode.  I had bumped my shin, broke the skin and began bleeding.  The bleeding took forever to stop so I stopped the aspirin.  I’ve cut myself since and not had any difficulties coagulating.

Annual wellness visit is in a few months.  I’ll show the app to my doctor and see what he recommends.

Great little app by the way.

Daily Aspirin – Yes or No?

Aspirin: FDA Says ‘No’ Others Say ‘Yes’.

I found this article quite helpful in my own decision regarding whether or not to continue my daily aspirin 81 mg dose.

The bump I gave myself on the shin a few weeks ago that bled profusely and took hours to clot was also quite helpful in my decision regarding whether or not to continue my daily aspirin 81 mg dose. 

Update 06.06.14

Check out the following link.  If you’re an older male you might find this of interest.

Update 07.26.14

This link takes you to the 2012 Circulation article.


Update 08.04.14

More links for your reading and research pleasure.

Aspirin May Not Protect Against Cardiovascular Disease –

Benefits of aspirin more modest than previously believed — St George’s, University of London.

Researchers from Professor Kausik Ray’s group at St George’s, University of London investigated the drug’s effectiveness in primary prevention and the prevalence of side effects. They also assessed if aspirin had any impact on the risk of death from cancer among people considered at risk of cardiovascular disease.

They analysed data from nine clinical trials involving over 100,000 participants without a history of cardiovascular disease. Half of the participants took aspirin and half took a placebo. The average participant in the aspirin arm of these trials took aspirin for about six years.

The researchers found that although aspirin in conventional daily or alternate day doses reduced the risk of total cardiovascular disease events by 10 per cent, this was largely due to a reduction in non-fatal heart attacks. It did not include a reduction in other cardiovascular disease events including death from heart attack, or fatal or non-fatal stroke.

The study also showed that this benefit was almost entirely offset by a 30 per cent increase in risk of life-threatening or debilitating internal bleeding events. This means that while one cardiovascular disease event was averted for every 120 people treated with aspirin for about six years, one in 73 people suffered from potentially significant bleeding during the same period.

ASA May Reduce CVD and All-Cause Mortality in T2DM

Aspirin Is Associated With Reduced Cardiovascular and All-Cause Mortality in Type 2 Diabetes in a Primary Prevention Setting — Diabetes Care

RESULTS There were 160 deaths (24.6%) during follow-up, with 70 (43.8%) due to CVD. In Kaplan-Meier survival analysis, there was no difference in either CVD or all-cause mortality in aspirin users versus nonusers (P = 0.52 and 0.94, respectively, by log-rank test). After adjustment for significant variables in the most parsimonious Cox models, regular aspirin use at baseline independently predicted reduced CVD and all-cause mortality (hazard ratio [HR] 0.30 [95% CI 0.09–0.95] and 0.53 [0.28–0.98[, respectively; P ≤ 0.044). In subgroup analyses, aspirin use was independently associated with reduced all-cause mortality in those aged ≥65 years and men.

CONCLUSIONS Regular low-dose aspirin may reduce all-cause and CVD mortality in a primary prevention setting in type 2 diabetes. All-cause mortality reductions are greatest in men and in those aged ≥65 years. The present observational data support recommendations that aspirin should be used in primary CVD prevention in all but the lowest risk patients.