Aspirin Use To Prevent 1st Heart Attack or Stroke Should Be Curtailed, US Panel Says 87
Doctors should no longer routinely start most people who are at high risk of heart disease on a daily regimen of low-dose aspirin, according to new draft guidelines by a U.S. panel of experts. The New York Times reports: The proposed recommendation is based on mounting evidence that the risk of serious side effects far outweighs the benefit of what was once considered a remarkably cheap weapon in the fight against heart disease. The U.S. panel also plans to retreat from its 2016 recommendation to take baby aspirin for the prevention of colorectal cancer, guidance that was groundbreaking at the time. The panel said more recent data had raised questions about the benefits for cancer, and that more research was needed.
On the use of low-dose or baby aspirin, the recommendation by the U.S. Preventive Services Task Force would apply to people younger than 60 who were at high risk of heart disease and for whom a new daily regimen of the mild analgesic might have been a tool to prevent a first heart attack or stroke. The proposed guidelines would not apply to those already taking aspirin or those who have already had a heart attack. The U.S. task force also wants to strongly discourage anyone 60 and older from starting a low-dose aspirin regimen, citing concerns about the age-related heightened risk for life-threatening bleeding. The panel had previously recommended that people in their 60s who were at high risk for cardiovascular disease consult their doctors to make a decision. A low dose is 81 milligrams to 100 milligrams.
The task force proposals follow years of changes in advice by several leading medical organizations and federal agencies, some of which had already recommended limiting the use of low-dose aspirin as a preventive tool against heart disease and stroke. Aspirin inhibits the formation of blood clots that can block arteries, but studies have raised concerns that regular intake increases the risk of bleeding, especially in the digestive tract and the brain, dangers that increase with age. "There's no longer a blanket statement that everybody who's at increased risk for heart disease, even though they never had a heart attack, should be on aspirin," said Dr. Chien-Wen Tseng, a member of the national task force who is the research director of family medicine and community health at the University of Hawaii. "We need to be smarter at matching primary prevention to the people who will benefit the most and have the least risk of harms." Those who are already taking baby aspirin should talk to their doctor.
On the use of low-dose or baby aspirin, the recommendation by the U.S. Preventive Services Task Force would apply to people younger than 60 who were at high risk of heart disease and for whom a new daily regimen of the mild analgesic might have been a tool to prevent a first heart attack or stroke. The proposed guidelines would not apply to those already taking aspirin or those who have already had a heart attack. The U.S. task force also wants to strongly discourage anyone 60 and older from starting a low-dose aspirin regimen, citing concerns about the age-related heightened risk for life-threatening bleeding. The panel had previously recommended that people in their 60s who were at high risk for cardiovascular disease consult their doctors to make a decision. A low dose is 81 milligrams to 100 milligrams.
The task force proposals follow years of changes in advice by several leading medical organizations and federal agencies, some of which had already recommended limiting the use of low-dose aspirin as a preventive tool against heart disease and stroke. Aspirin inhibits the formation of blood clots that can block arteries, but studies have raised concerns that regular intake increases the risk of bleeding, especially in the digestive tract and the brain, dangers that increase with age. "There's no longer a blanket statement that everybody who's at increased risk for heart disease, even though they never had a heart attack, should be on aspirin," said Dr. Chien-Wen Tseng, a member of the national task force who is the research director of family medicine and community health at the University of Hawaii. "We need to be smarter at matching primary prevention to the people who will benefit the most and have the least risk of harms." Those who are already taking baby aspirin should talk to their doctor.
Horse paste or nothing. (Score:5, Funny)
Re:Horse paste or nothing. (Score:5, Informative)
Sorry, but I get my medical advice from instagram and the mentally retarded.
You are in luck! They make aspirin for horses. You can probably pick some up at the same place you buy your paste.
https://www.smartpakequine.com... [smartpakequine.com]
Re:Horse paste or nothing. (Score:4, Funny)
> and the mentally retarded
Also, antibiotics! That's the shit they feed to pigs and chickens to make them grow bigger... we already have an obesity problem in the US, why are they giving it to humans!
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Very very little evidence that ivarmecting works against covid-19, or any virus, the minor study that everyone points to was withdrawn for problems. Also, do NOT self medicate! Just like hydroxychlroquine, you can seriously damage yourself by not knowing what the safe dosage is for humans.
If your doctor is not prescribing a medicine, then do not take it on your own! That's not government marxism trying to keep you sick and compliant, it's fucking common sense!
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I dont know if it works or not.
But its quite disingenuous to point to 1 study and say it doesnt work.
Here is a list of the studies : https://c19ivermectin.com/ [c19ivermectin.com]
There are also Ivermecting treatment guidlines for Covid. Probably in the under evaluation drugs.
https://www.covid19treatmentgu... [nih.gov]
I agree, though, do not self medicate.
The media need to get their heads out of their asses and stop pushing propaganda and actually do journalism though.
What the reality is as to its efficacy, I dont know. But the horse pas
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You might as well. You'll be ahead of the curve when a few decades from now the experts change their minds about that, too. Hell, you might as well pound horse paste up your ass. Sooner or later, someone will claim it cures something. Maybe it'll even be the experts.
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Aspirin, fortunately has been a commonplace remedy for approximately 3500 years. The doses in willow bark were mild, and people with physical lives had more injuries and muscle strains that benefited from a safe, mild analgesic. Compliance is one of the problems with aspirin: people do tend to take two because they missed yesterday's dose, and to take more than they need.
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Be sure to get the best horse paste [germanshop24.com]
I religiously took low dose aspirin for 20 years (Score:1)
until the medical establishment decided that was a bad idea.
Re:I religiously took low dose aspirin for 20 year (Score:5, Informative)
Geez, you could have taken 5 seconds to look at the article linked in the summary, in which you will find a link to the research review that contains the fucking studies they relied on and their fucking data.
https://www.uspreventiveservic... [uspreventi...kforce.org]
I love people who try to sound smart saying "I want to see their data so I can do my own research" when they lack even the most common-sense skills required to make an evaluation of the data in front of them, or even the ability to follow a few links. "I can't wait for them to share their data" can be translated as "I'm too lazy to look at data, and no matter what that data might say, I have my mind made up."
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I look at it this way. Taking the advise of the exports is probably a more informed crap shoot than taking the advise of J. Random Asshole on the internet.
But don't kid yourself. Any course of action is still a crap shoot.
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This is what the healthy skepticism of a scientific mindset actually looks like.
Have you ever performed this sort of complicated multi-variable analysis on something which you could perform repeatable objective controlled experimentation on instead? Probably not because why would you? Give it a shot sometime. Apply some of these complicated schemes meant to tease meaning from the noise on different plausible sounding ideas. You'll be appalled at the results and your respect for the significance
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Re:I religiously took low dose aspirin for 20 year (Score:5, Informative)
When recommendations for medical treatment are put into guidelines, every single recommendation is associated with two things. One is a level of evidence and the second is a strength of the evidence.
Here is the old guidelines for preventing heart disease, from 2019: https://www.jacc.org/doi/abs/1... [jacc.org]
It's a free PDF.
The explanation of level of evidence and strength of the evidence is on page e182.
According to page e204 (28 of the PDF, I think), the level of evidence is A (very good) but the strength of evidence is IIb, which is quite weak, suggesting that it may be overturned in the future.
Obviously the level of evidence has changed since this guideline came out.
That's why physicians "practice" medicine. There's always new information coming out and we change what we do.
BTW, I'm a cardiologist.
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Sorry for screwing up by bold. Forgot a close tag. :-/
Re:I religiously took low dose aspirin for 20 year (Score:5, Funny)
BTW, I'm a cardiologist.
Thank God; I thought you might be a web developer!
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According to page e204 (28 of the PDF, I think), the level of evidence is A (very good) but the strength of evidence is IIb, which is quite weak, suggesting that it may be overturned in the future.
Unfortunately, these extremely valuable pieces of information never get disseminated to the public. All the public knows is that another former wonder drug is now considered harmful.
The field of medicine is in the middle of a massive public relations crisis.
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Aspirin has long been known to have problems when taking in high dosages. It can cause stomach distress or ulcers, the blood thinning effect that may help with some heart problems can also cause bleeding.
Re:I religiously took low dose aspirin for 20 year (Score:5, Informative)
"Tobacco studies proved nicotine safe for decades."
Nicotine itself is highly addictive but only somewhat detrimental to health. The stuff you smoke that kills you are the tars, particulate matter, and other toxic and carcinogenic chemicals produced by burning tobacco.
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https://news.stanford.edu/news... [stanford.edu]
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Nicotine is still bad for you. Doctors will still consider it a risk factor when they are considering whether to perform surgery. See this for example [nih.gov].
"Nicotine replacement carries similar risks as continued smoking and is not as safe as abstinence in the perioperative period in plastic surgery patients. Importantly, patients who stopped smoking for the surgery had equivalent risk for postoperative complications as patients who had never smoked."
That said, vaping is 100x better than smoking, because it lacks tar, and many other carcinogens. There are chemicals in cigarettes that literally modify your DNA, but are not present in vape.
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And indeed, nicotine is safe, in reasonable doses. It's a good way to push ones mind a bit harder and get more focus. Like caffeine.
That was never the problem with tobacco.
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And indeed, nicotine is safe, in reasonable doses.
[citation needed].
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There are plenty of studies. The ones that show issues with nicotine do it in connection with already serious conditions, where it makes sense that a stimulant will add stress to the body. But in a healthy individual, stimulants provide a boost, when not abused.
https://www.forbes.com/sites/s... [forbes.com]
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I wasn't endorsing or criticizing the conclusion. I was merely pointing out to the guy who was "waiting to see the data" that the data was right there for the seeing.
Re:I religiously took low dose aspirin for 20 year (Score:5, Insightful)
Ethical doctors, and also other ethical professionals who are still making discoveries in their field, will tell their clients the best advice they have available, and can also discuss the risks and benefits of various approaches. As they learn more, that advice will change over time.
If a person can't handle the fact that ethical professionals people make new discoveries, learn new things, and that advice can change, then what they need need is... a charlatan who will promise amazing benefits with no risks. Plus, a charlatan's advice stays consistent because 1) they don't bother to learn anything new for other people's benefit, and 2) there's a new sucker every day so even if they know they're selling something bad, they stick to the same story as long as it works to bring in revenue.
Re: I religiously took low dose aspirin for 20 yea (Score:4, Insightful)
The job of ethical professionals doing their best with incomplete data is that medicine is an ancient profession that has yet to fully shed the millenia of baggage it has acrued.
Among the most harmful elements of that baggage is an instinct toward paternalism and toward hiding or discounting any ambiguity or uncertainty in the data used to establish recommendations.
An equally harmful piece of baggage that one finds in the ancient professions (medicine, law, religion, prostitution) is a severe allergy to rigorous mathematical analysis. This impedes the ability of practitioners to understand scientific evidence themselves (telling the difference between absolute versus relative risk, truly groking Poisson statistics, Simpson's paradox, Bayes's paradox, etc), thereby hindering their ability to provide accurate guidance to their patients.
Sometimes the result is mere rote repetition of the sort one may expect of newly converted missionaries spreading the good news before their own brains have managed to digest it.
We've seen this on display in covid: low-n studies for HCQ or ivermectin being compared against high-n clinical trials of vaccines or mulnopiravir or remdesevir or dexamethasone. And on the other side we've seen it from public health authorities denying the existence and natural immunity by citing numbers out of Kentucky showing vaccines were Twice As Good as natural immunity without acknowledging the teeny tiny numbers of breakthroughs/reinfections they were comparing, and outright ignoring data out of other countries showing the exact opposite result...with equally tiny numbers.
Shouting "science!" as a way to ward of criticism of messaging or message is a product of this baggage, acquired in the pre-scientific days when invoking the name of a diety was thought to be an effective way to ward off evil.
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Yes. And also things like intentionally misleading the public for some notion of a greater good, like Fauci and the mask thing early in the pandemic. But in my opinion, these are not ethical acts. People deserve to know the truth, even when the truth is that we don't really know.
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I'm interested to know what caused someone to moderate my comment above as a troll.
I agree that "hiding or discounting any ambiguity or uncertainty in the data used to establish recommendations" is harmful, by creating a false sense of security in the recommendation.
When Fauci said not to wear masks early on, and later admitted [thestreet.com] that this was really motivated b
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Follow the science!
No! NO! Not THAT science!
But people can still do the math.
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Why create a cure, when a thousand palliatives will do?
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Wish I could mod this up...
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If you didn't have internal bleeding or a heart attack in that time, then it worked.
I wonder if mitigation factors for internal bleeding might be more effective (lower dose, aspirin every other day, etc.), especially given how cheap aspirin is.
It has been a while since I looked at the data of how effective aspirin is in preventing an ischemic event, so I'd really have to consider that in light of the new recommendations (especially since there isn't a commensurate warning against aspirin for pain, which sev
Re:I religiously took low dose aspirin for 20 year (Score:5, Informative)
This change is for people at risk, who have not had a heart attack.
Existing heart patients are safe to ignore this change, for the most part.
The side effects (from the PDF):
"In primary prevention populations, low-dose aspirin reduces major CVD
events, MI and ischemic stroke, but also increases major GI bleeding, extracranial bleeding, and
intracranial bleeding."
are all primary side effects of the blood thinner you are more than likely to be taking.Your cardiologist is unlikely to change the course that includes daily aspirin.
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The medical establishment decided that while it still works, for some (elder people who haven't had a stroke yet) the risk outweighs the benefits.
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Re:But we know everything there is to know about (Score:4, Informative)
Re:But we know everything there is to know about (Score:4, Interesting)
One difference is that preventive aspirin is something you take every day for decades, in contrast to mRNA vaccines where the active ingredient is gone forever within days.
Another important point is that we have lifetimes of experience with vaccines in general and we know when bad effects show up. It's within two months: https://www.chop.edu/news/long... [chop.edu], https://www.uab.edu/reporter/r... [uab.edu]
We know exactly what the risks are from the COVID vaccines and how many per million will experience each one. Any way I do the estimate, they come out four orders of magnitude safer than COVID.
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There are people like you who say, "We don't know everything about the vaccine, it's not safe!" but then say, "We know COVID is deadly but I'm going to risk it!"
Re: But we know everything there is to know about (Score:2)
I think the risk of Covid and spreading it far outweighs the risk of vax side effects.
Got the vax, no side effects, all is good.
Truth is, all medications carry some degree of risk. I don't hear the same "vax bad" bruhaha over the annual flu shot.
Devils in the details (Score:2)
...like who funded these new insights "by several leading medical organizations and federal agencies"?
Aspirin, that extremely low cost, generic drug that been around for ever being pushed aside for....?
I'm being cynical, I know, but it's a simple fact that where there's money to be made, and really good money, decisions and policies can be bought and researchers need patrons.
Here in New Zealand we had a referendum on legalising weed and the "No" campaign was funded by pharma. It won.
Another cheap drug that
Is salt still bad for you? (Score:2)
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Do you have borderline hypertension? Do you need to make a weigh-in for a wrestling match?
Whether or not something is "bad" for you is often variable.
Seemed kind of obvious to me... no? (Score:3)
It appears kind of obvious to me that taking Aspirin long-term as a anti-clotting drug to prevent heart-attack or stroke is not really a solution of any kind and it always felt strange to hear this recommendation from others, like For example when my mother told me that one of her doctors recommended it and I advised against it.
I wish to qualify this by stating that I'm a technical layman with no medical background and not even a high-school education. However, from my commonly derived knowledge the underlying issues of infarctions and ventricular obstructions are usually plaque built-up and hypertension level 2 or higher that would not be affected the decreased ability of the platelets to clot, from which my mother does not suffer.
It almost appears that the hand of big pharma had a way of creating studies to push the out-of-favor Aspirin (acetylsalicylic acid) as a solution to continue selling their product which would no longer pass or quality under FDA rules for drugs, unless it was already grandfathered-in 1938 for the 1906 FDA act, since the toxicity levels of Asprin are too high for the general public based on LD50 (median Lethal Dose for 50% Population) [something I've heard mentioned]. I just checked and for a 80kg average weight person it only takes 16,000mg or (16g) of Aspirin to kill them half the time, so that's about ~50-pills at 325mg each or one bottle from the drug store. There are also side-effects that a few people experience from Aspirin usage. That amount could possibly permanently damage or kill the liver though and cause a slow death instead while waiting for a new liver from the organ-transplant list.
Now this new knowledge comes out confirming my hunch that taking Aspirin long-term is not beneficial since the side-effect of stopping blood clotting in the gastrointestinal track where many small abrasions and ruptures form under normal circumstances, intramuscular tears from abnormal motion, and intracranial small vascular ruptures can be made worse by taking Aspirin since it prevents them from clotting and healing leading to internal bleeding hemorrhages which are very bad.
I just had a feeling that taking Aspirin as a preventative medication sounded weird and wrong to me.
PS: Why is this storing showing up on Slashdot? This isn't Technical News, but it's interesting nontheless. Damn you BeauHD!
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Because we're old now, getting to the point where aspirin is news that matters.
Remarkably cheap? (Score:5, Interesting)
A year's supply of Aspirin costs about as much as a set of running shoes. But the running shoes do have other unintended side-effects such as not being perpetually out of breath, not looking like a fat slob, and exercise releases endorphins so you're going to have to give up your delicious anti-depressants.
It never ceases to amaze me how over-medicated Americans are. And my American colleagues who come to Europe for an assignment long enough that they actually visit a doctor are almost perplexed as to why doctors don't start with questions like "what drugs are you taking" and finish with "which one of these do you want me to prescribe to you".
I went to the doctor after my work medical diagnosed hypertension. I went home with a piece of paper describing a training regime, not a prescription like my mother did.
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I went to the doctor after my work medical diagnosed hypertension. I went home with a piece of paper describing a training regime, not a prescription like my mother did.
If more doctors did that, how would big pharma going to profit? That would be the end of the world!
The reason for American's obsession with drugs is simple, you have a for-profit health care system that breeds big for-profit pharma companies which want to sell more drugs to make more profit. Their ideal situation is a whole nation filled with legal drug addicts paying every cent they earn on drugs.
In places like Europe, they have a health care system that wants to make people healthy so they don't need to
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Running shoes won't help me because I have asthma. I can do short sprints fine, but I physically cannot do a long jog.
Stop shaming people for seeking medical care.
You must be (Score:2)
new to Slashdot?
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I'm not shaming you. I'm using what is known as an example with the implicit assumption that it doesn't apply to everyone. You have asthma, congrats. There are many other options available to you should you have heart disease risk that don't involve medicating you while you waste your worthless life away in front of the TV.
And if that's what you're doing, and using "medical care" as an excuse you absolutely deserve to be shamed.
You said it yourself, you can do short sprints fine. Why do you make excuses and
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Quit whining and start sprinting. HIIT is better for you anyway.
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The general point is that you can use exercise to treat most of those health problems and it doesn't even need to be jogging. Even walking around for half an hour each day can help and there are plenty of other ways to exercise that don't involve even using your legs. Just lifting weights (even some relatively light on
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I went to the doctor after my work medical diagnosed hypertension. I went home with a piece of paper describing a training regime, not a prescription like my mother did.
FWIW when I went to the doctor with hypertension in America, I came away with a 10 page dietary recommendation (DASH diet). So YMMV.
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Sounds like you went to one of those alternative medicine places, like if you didn't go home with a bag of pills, were you even at a qualified doctor? :-)
About time (Score:3)
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And you're putting yourself at risk for ischemic stroke... There's a reason you were on the blood thinners, which is that a stroke is worse than a nose bleed.
Get exercise, stop eating garbage food (Score:2)
So? (Score:2)
Ok, not for that, but it's beneficial for other things. I forget what, but for example it might be beneficial in protecting against colorectal cancer, or liver problems. The trouble with media's reporting is that one study looks at only one thing.
Honestly, I don't trust the "experts" anymore (Score:2)
..especially when something that has been around for centuries suddenly "is bad for you".
We have this Padded World Industrial Complex that has become real popular in normal times, and it has resulted in lighting a camp fire on the beach being outlawed. Everything that makes life worth living is "bad for you" and must be outlawed "for our saftey". X-{
Maybe the doctors in TFA are right, but they are going to have to contend with a public that is fed up with micromanagement and "everything will
Re: Honestly, I don't trust the "experts" anymore (Score:2)
" We have this Padded World Industrial Complex that has become real popular in RECENT times"