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The Not-so Hidden Risks of Aspirin, Is It Worth It?

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What you typically see with addition of aspirin is gi bleeds a little bit of bleeding from the stomach ulcer kind of stuff aspirin cardiovascular disease benefits appear to be again within the first one to two years of administration and the bleeding harms begin soon after aspirin initiation so after you start considering what the other side of this is you know

You get started down this path and you say well it’s a baby ask you know what’s the big deal once you get into the details it becomes a big deal because we’re talking about gi bleeding or stroke i mentioned that it got these recommendations have gotten a lot of coverage new york times headline aspirin used to prevent first heart attack or stroke should be curtailed

Us panel says as is typical that’s not what they said what they said is for people that have no cardiovascular disease that’s not the same as first heart attack or stroke is it and in fact what they said was for people without pre-existing cardiovascular disease and here’s the point i’ll make it now and i’ll make it again as we go in further into detail because

It’s a critical point it’s the point that keeps getting skipped over in headlines like this what they said is people that do not have pre-existing cardiovascular disease you remember we went back and we talked about the importance of plaque if you have plaque in your arteries you have pre-existing cardiovascular disease so if you go back and you look at guys like

Me and i’m not the only one here you’ll hear brad bail namey doneen we talk about the vail de nin community they talk about this issue a lot we confuse primary prevention versus secondary prevention and we assume that the only people that have pre-existing cardiovascular disease people like you see in this headline and unfortunately docs often assume that too the

Professionals that should understand this if you have plaque you don’t have to have had a heart attack or a stroke already to have pre-existing cardiovascular disease so here is what came out of this new york times article doctors should no longer routinely start most people at high risk of heart disease on a regular regiment of low dose aspirants so again a major

Misinterpretation the us task force also wants to strongly discourage anyone 60 or older from starting a low-dose aspirin regimen so again you go back to what was the previous interpretation and what was the previous quote preventive recommendation age 60 or older again a lot of previous ones were age 55 and older a few years ago it went from 55 up to 60 and now

They’re saying again if you’re thinking about that old guideline 60 or older take a baby aspirin don’t do that based on age alone you go to the bale dune community you go to me we never said age alone we said if you have plaque if you have pre-existing disease again why are they backing off exciting concerns about the age-related heightened risk for life-threatening

Bleeding strokes and gi bleeding now the proposed guidelines would not apply to those already taking aspirin or those who’ve already had a heart attack or as we said before those who have pre-existing disease i mentioned the esprit trial a few minutes ago this was one of the first trials to come out to start saying should we be starting people every 60 year old

Out there on baby aspirin whether they have plaque or cardiovascular disease or not so you

Transcribed from video
The Not-so Hidden Risks of Aspirin, Is It Worth It? By Ford Brewer MD MPH