Daily use of Aspirin

DeadlyTwig

Recently, I've heard of a number of people who take aspirin on a daily basis even though they haven't been recommended to do so. I understand the benefits of this but also the risks.

Does anyone take It everyday or know anyone who is young-ish and does??

Would you recommend it daily in lower doses for safe use?

A lecturer two weeks ago told us that he would have everyone in Ireland taking it daily if he could!!

Jumpy

Depends on how many stomach ulcers you want really.

As far as I know, aspirin should only be taken daily when recommended by a doctor. Aspirin(the brand) has a special low dose product with a coating specially to prevent stomach upset during daily use, but I'd definitely say you should see your GP before you start taking it.

Have a look at aspirin.com, but remember, they're not doctors, they're just trying to sell a product.

SomeDose

DeadlyTwig wrote: »

Recently, I've heard of a number of people who take aspirin on a daily basis even though they haven't been recommended to do so. I understand the benefits of this but also the risks.

Does anyone take It everyday or know anyone who is young-ish and does??

Would you recommend it daily in lower doses for safe use?

A lecturer two weeks ago told us that he would have everyone in Ireland taking it daily if he could!!

Assuming these people are otherwise fit and healthy with no cardiovascular history, what is their reasoning (and that of your lecturer's) for taking daily aspirin? Recent data suggest there is no clear benefit from daily aspirin unless you have already had a cardiovascular event such as a stroke or heart attack.

In fact, as far as I'm aware, low-dose aspirin is prescription-only in Ireland. So I'm puzzled as to how these people are using it if it hasn't been recommended by their doctor. Unless of course they're self-medicating with the OTC analgesic 300mg dose every day, which would clearly be stupid...

ZYX

The big question is, if you put 1000 normal healthy people on aspirin and compared them to 1000 people not on aspirin who would do better?
Those on aspirin would have less heart attacks and less thrombotic strokes (strokes caused by clots) but would have more haemorrhagic strokes (caused by bleeding into brain) and more intestinal bleeds.
On average (as far as I know), based on current evidence both groups will do just as well; they will just die of different things. You need to balance the risks. The greater your risk of heart disease then the better you are likely to do on aspirin and visa versa. You must also consider possibility of inherited bleeding disorders. eg 1-2% of people in Ireland have Von Willebrands disease (most do not know they have it) or some other bleeding disorder. If you gave every person with VonWillebrands disease aspirin then you would be doing more harm than good.

clare876

I believe the current thinking is people should only take aspirin if they have evidence of coronary artery disease on angiography, as there is a one in 1000 risk of haemorrhagic stroke. My mother suffered one and has lost her independence at only 60. People should be careful about aspirin the effects have life changing consequences. Saying that it is very important in the treatment of coronary heart disease.

DeadlyTwig

I wasn't thinking of taking it. I was just curious as to how widespread the use was.
My lecturer was working on the basis of benefits outweighing the risks I suppose. Although the risk of haemorrhage is quite high.

Is aspirin prescription only? Surely not. How low could a dose be to be effective?

FluffyCat

I had, quite possibly, the same lecturer tell us that. At 75mg strenght, which is what he was talking about, is used as an anti-platelet to prevent MI, stroke, DVT etc. At this strenght the chances of ulcer is low. However taking other NSAIDs along with this could provoke ulcer in the long-term. The lecturer saying everyone should take it is for patients with no other real health issues. When a patient is on other meds and has multiply health conditions, adverse effects may occur.
Aspirin at 75mg is Rx only

Aspirin at OTC level is pain relief and is NOT recomended to be taken long term unless the doctor says.

ZYX

FluffyCat wrote: »

I had, quite possibly, the same lecturer tell us that. At 75mg strenght, which is what he was talking about, is used as an anti-platelet to prevent MI, stroke, DVT etc. At this strenght the chances of ulcer is low. However taking other NSAIDs along with this could provoke ulcer in the long-term. The lecturer saying everyone should take it is for patients with no other real health issues. When a patient is on other meds and has multiply health conditions, adverse effects may occur.
Aspirin at 75mg is Rx only

Aspirin at OTC level is pain relief and is NOT recomended to be taken long term unless the doctor says.

Just for information. The mechanism of arterial and venous thrombosis are different so aspirin is not recommended for prevention of DVTs.

SomeDose

FluffyCat wrote: »

I had, quite possibly, the same lecturer tell us that. At 75mg strenght, which is what he was talking about, is used as an anti-platelet to prevent MI, stroke, DVT etc. At this strenght the chances of ulcer is low. However taking other NSAIDs along with this could provoke ulcer in the long-term. The lecturer saying everyone should take it is for patients with no other real health issues. When a patient is on other meds and has multiply health conditions, adverse effects may occur....

The lecturer is missing the point. Regardless of a person's co-morbidities or current medication (or lack thereof), there now appears to be no significant net benefit to justify low-dose aspirin for primary prevention of CVD. This also applies to people with diabetes and those with predicted 10-year CVD risk, who until now would have been thought to benefit from aspirin for primary prevention.

ZYX wrote:

Just for information. The mechanism of arterial and venous thrombosis are different so aspirin is not recommended for prevention of DVTs.

Indeed, although I know one or two orthopaedic surgeons who would insist otherwise!

charlieroot

Got a link to any sources on the above thanks.

SomeDose

I'm assuming you have BMJ access...

Summary article here http://www.bmj.com/content/340/bmj.c1805.full

In terms of diabetic patients, the POPADAD trial
http://www.bmj.com/content/337/bmj.a1840.full?sid=4b27a8e5-cde6-4855-93e4-411765d2ad6a

and meta-analysis here
http://www.bmj.com/content/339/bmj.b4531.full?sid=4b27a8e5-cde6-4855-93e4-411765d2ad6a

The ASCEND study in diabetic patients is yet to conclude, but should be interesting as it will have a much larger study population than POPADAD.

Vorsprung

SomeDose wrote: »

I'm assuming you have BMJ access...

Summary article here http://www.bmj.com/content/340/bmj.c1805.full

In terms of diabetic patients, the POPADAD trial
http://www.bmj.com/content/337/bmj.a1840.full?sid=4b27a8e5-cde6-4855-93e4-411765d2ad6a

and meta-analysis here
http://www.bmj.com/content/339/bmj.b4531.full?sid=4b27a8e5-cde6-4855-93e4-411765d2ad6a

The ASCEND study in diabetic patients is yet to conclude, but should be interesting as it will have a much larger study population than POPADAD.

Interesting stuff, thanks for posting that

pwd

ZYX wrote: »

The big question is, if you put 1000 normal healthy people on aspirin and compared them to 1000 people not on aspirin who would do better?
Those on aspirin would have less heart attacks and less thrombotic strokes (strokes caused by clots) but would have more haemorrhagic strokes (caused by bleeding into brain) and more intestinal bleeds.
On average (as far as I know), based on current evidence both groups will do just as well; they will just die of different things. You need to balance the risks. The greater your risk of heart disease then the better you are likely to do on aspirin and visa versa. You must also consider possibility of inherited bleeding disorders. eg 1-2% of people in Ireland have Von Willebrands disease (most do not know they have it) or some other bleeding disorder. If you gave every person with VonWillebrands disease aspirin then you would be doing more harm than good.

That's a very interesting statistic about von Willebrand's disease. Can you give a source please?
I never realised it was common. [I should have realised it was common, because the NCHCD is always busy, and I know haemophilia is uncommon.]

You are right of course with your point about aspirin. It is counter-indicated for any use at all for people with clotting disorders, never mind taking it daily!

crazy dude

The one guy I did know who took aspirin (unprescribed) prophylactically was a pharmacist and while on holiday an ulcer bleed requiring his whole blood volume be transfused! He nearly died!
I wouldn't mind being on a statin prophylactically though if I could get the liver function tests done or find a doctor who would agree. I suspect there will eventually be prophylactic prescribing in healthy people - a statin and maybe something to adjust blood pressure just a little to prevent arteries hardening over the long term and extend life