Do you still take low-dose aspirin daily?

[ChicagoGranny]

And despite the sensationalist press reports about the side effects of PPIs, there is really no other class of medication that I can think of that is as safe as PPIs.

Thank you for saying that.

As a community GI specialist, I have seen all kinds of NSAID and aspirin induced ulcer bleeds.

Yep, after a few years of coated 81 mg aspirin daily, Gramps developed a stomach bleed. We both quit aspirin. Fortunately, his bleed heeled quickly.

[jnk...]

I don't think PPI will do much for risk of hemorrhagic stroke, though.

[ChicagoGranny]

I don't think PPI will do much for risk of hemorrhagic stroke, though.

Doesn't aspirin increase the risk of incidence and risk of severity of hemorrhagic stroke?? Yes, it does.

[chunkyfrog]

I don't think PPI will do much for risk of hemorrhagic stroke, though.

Doesn't aspirin increase the risk of incidence and risk of severity of hemorrhagic stroke?? Yes, it does.

Aspirin prevents clotting--good for blockage strokes--bad for a hemorrhagic stroke. (Brain bleed)

[jnk...]

I don't think PPI will do much for risk of hemorrhagic stroke, though.

Doesn't aspirin increase the risk of incidence and risk of severity of hemorrhagic stroke?? Yes, it does.

Yes. Exactly Glad you actually understood my point for once, that PPI may help prevent GI bleeds, but not other serious bleeds. So PPI with aspirin will not reduce all risks of aspirin protocols. Aspirin increases risk of hemorrhagic stroke. PPI will not fix that risk.

[Janknitz]

Here's an interesting perspective on the aspirin question from a cardiologist who takes a closer look at a patient's risk based on cardiac imaging before deciding if aspirin (and other interventions) are appropriate: https://thefatemperor.com/bill-blanchet ... odcast-17/ Addresses aspirin therapy about 13 minutes in. Transcript here: https://thefatemperor.com/wp-content/up ... ast-17.pdf

Also a good discussion on fish oil, the efficacy of which is also in question.

[ChicagoGranny]

Also a good discussion on fish oil, the efficacy of which is also in question.

Gramps and I also quit taking fish oil. We try to eat cold-water, oily fish twice a week. Doctor agreed.

[DavidY]

I will be asking my cardiologist about this during today's appointment....I would be very surprised if he took me off it. Trying to wean off my beta blocker currently.

Had a MI and a stent last July. Been on CPAP since Feb 2018.

Dave

[RobertS975]

Study published in 2005 indicates that the risk of hemorrhagic stroke from ASA use is small. Other meta-analyses on the subject would tend to indicate similar findings and that the prevention of thrombotic strokes as well as myocardial infarcts would appear to far outweigh the risks of aspirin use. Published in the medical journal Stroke 2005:

Low-dose aspirin is an important therapeutic option in the secondary prevention of myocardial infarction (MI) and ischemic stroke, especially in light of its unique cost-effectiveness and widespread availability. In addition, based on the results of a number of large studies, aspirin is also widely used in the primary prevention of MI. This review provides an update of the available data to offer greater clarity regarding the risks of aspirin with respect to hemorrhagic stroke, as well as insights regarding patient selection to minimize the risk of this complication.
SUMMARY OF REVIEW:

In the secondary prevention of cardiovascular, cerebrovascular, and ischemic events, the evidence supports that the benefits of aspirin treatment significantly outweigh the risk of a major hemorrhage. The evidence from primary prevention of MI studies, including that from the recent Women's Health Study evaluation of aspirin use in healthy women, demonstrate that the increased risk for hemorrhagic stroke is small, is comparable to the secondary prevention studies, and fails to achieve statistical significance. A reasonable estimate of the risk of hemorrhagic stroke associated with the use of aspirin in primary prevention patients is 0.2 events per 1000 patient-years, which is comparable to estimates of the risk associated with the use of aspirin in secondary prevention patients.
CONCLUSIONS:

When considering whether aspirin is appropriate, the absolute therapeutic cardiovascular benefits of aspirin must be balanced with the possible risks associated with its use, with the most serious being hemorrhagic stroke.

[ChicagoGranny]

Study published in 2005 indicates that the risk of hemorrhagic stroke from ASA use is small. Other meta-analyses on the subject would tend to indicate similar findings and that the prevention of thrombotic strokes as well as myocardial infarcts would appear to far outweigh the risks of aspirin use. Published in the medical journal Stroke 2005:

A lot of work has been done since 2005. The 2018 recommendations of the U.S. Preventative Services Task Force are more specific.

The USPSTF recommends initiating low-dose aspirin use for the primary prevention of cardiovascular disease (CVD) and colorectal cancer (CRC) in adults aged 50 to 59 years who have a 10% or greater 10-year CVD risk, are not at increased risk for bleeding, have a life expectancy of at least 10 years, and are willing to take low-dose aspirin daily for at least 10 years.

The decision to initiate low-dose aspirin use for the primary prevention of CVD and CRC in adults aged 60 to 69 years who have a 10% or greater 10-year CVD risk should be an individual one. Persons who are not at increased risk for bleeding, have a life expectancy of at least 10 years, and are willing to take low-dose aspirin daily for at least 10 years are more likely to benefit. Persons who place a higher value on the potential benefits than the potential harms may choose to initiate low-dose aspirin.

The current evidence is insufficient to assess the balance of benefits and harms of initiating aspirin use for the primary prevention of CVD and CRC in adults younger than 50 years.

The current evidence is insufficient to assess the balance of benefits and harms of initiating aspirin use for the primary prevention of CVD and CRC in adults aged 70 years or older.

https://www.uspreventiveservicestaskfor ... and-cancer

[jnk...]

. . . MI and a stent . . .

Good enough reasons for me.