Tag Archives: aspirin

TAKE 100 ASPIRIN AND CALL ME NEXT YEAR

Should you take an aspirin daily to prevent strokes and heart attacks?  That question seems simple enough, and based on general comments you might think it is a good idea, but the scientific data on daily aspirin remains mixed.

Yes….aspirin prevents many heart attacks and strokes, but it does have side effects that are significant.  These include: excessive bleeding, including bleeding strokes….and stomach irritation from aspirin (which is known to cause ulcers).

Bayer-AspirinFor the average person these negatives are approximately equal to the positive preventive effects of aspirin, but there is an additional benefit to aspirin that is definitely worthwhile and that is the prevention of colon polyps and colon cancer.  Aspirin has been shown to confer a benefit in this regard, and when you add this benefit to the heart attack & stroke benefit, this definitely outweighs the complications.

I recommend for most people who are interested in taking aspirin daily that they purchase a bottle of #100 Coated Baby Aspirin.  Then, over the course of a year, they take the entire bottle, which is approximately 1 every 3 days or so.  With aspirin effects lasting 7 days, this program will minimize the bleeding issues while maintaining all of the potential benefits of blood thinning.

 

WHAT HAPPENED TO JAMES GALDOFINI?

james-gandolfiniI was shocked to hear about the unexpected death of James Gladofini, the well-know star of the SOPRANOS HBO SERIES.

Although the details are not available, I already know that this will get some 50 year-old guys wondering whether they are at risk for sudden death due to coronary artery disease.  It will raise awareness.

Of course, the particulars in his case, are hard to know.   From appearances he was a barrel-chested overweight fellow who ‘huffed and puffed’ often during his acting, and ate a lot of steaks (if you can believe his characters actions…..perhaps not true).  That said, how does a 51 year-old man die suddenly of a massive heart attack.

Certainly, sudden and unexpected death is possible for any of use (sorry to say).  We can all  kid….but yes….that truck really could run us off the sidewalk!! (I’m hoping not….but…hey…let’s be real!)

Beyond these issues, the real question is preventing this from happening to you….how do you do it?

1.  Exercise regularly.  This is the best method to prevent a heart attack or to survive it …..it’s not just about ‘not getting’ your heart attack…it’s living through it, and people who are in better shape….survive such stresses better and more often.  Read THE KEYS , my simple book on suggestions for living longer and healthier,  for some direction here and what your minimum exercise requirement is.)

2.  Know your cholesterol and blood pressure.  These two items have the greatest impact on your risk, independent of any actions you may or may not take.  Come on in to check on these and see if you need attention to these.

3.  Lose some weight…if you are significantly overweight.   Now….James Gladofini was probably obese as defined by a BMI (body mass index) of over 30.  Being overweight is not a concern….being obese is!   Again….figure our your BMI by looking at THE KEYS and the BMI chart in the back

4.  Take a baby aspirin daily.  This is a very simple method for preventing heart disease and is particularly a consideration for men (less so for women as they have much lower risk…age-for-age…as men.)

5.  Come in and get a heart check up.  A simple treadmill test is very diagnostic in this regard and very reassuring, or we can do a CT scan of the heart to check for Calcium deposition in the coronary arteries.

Of course….we don’t know Mr. Gladofini’s heart history…it may have been substantial, he may have had many heart stents in the past and a long history of heart disease….. but you can do a lot to prevent this from happening to you and to give yourself peace of mind!

 

MORE ON ASPIRIN…….

Aspirin may be among the topics most discussed in these pages and today there is another study on aspirin, this time looking at coated aspirin and perhaps it’s reduced effectiveness compared to plain aspirin.

I think most people use coated aspirin now as it is the type most advertised, and it does provide some benefit in reducing the potential for stomach irritation.  That said, it is possible that this ‘coating’ will alter the pharmicodynamics of the aspirin.

In this recent study in the journal Circulation, plain aspirin was found more effective that coated aspirin, in which people initially showed some resistance to the aspirin effect.  Retesting however, showed that those people initially not gaining the blood thinning effects of aspirin, eventually showed a response.

So…what are we to make of this information?  Not much.  Perhaps there is a benefit to ‘plain’ aspirin, but if you are taking coated aspirin regularly it appears to be just as effective.

Also, another comment, on aspirin resistance.   There are a lot of articles written on this topic, suggesting that patients get checked for aspirin resistance, but in my practice I have never seen one documented case of aspirin resistance, and I have checked people for this in the past.  In addition, in this journal article, they too found really no evidence of widespread aspirin resistance.  So, another practical point:  Don’t worry about aspirin resistance.  If you are an aspirin-taker….feel confident in it’s effectiveness.

http://circ.ahajournals.org/content/early/2012/12/04/CIRCULATIONAHA.112.117283.abstract

http://www.nytimes.com/2012/12/05/business/coating-on-buffered-aspirin-may-hide-its-heart-protective-effects.html

ASPIRIN…WONDER DRUG….CONTINUES TO AMAZE

Aspirin is just over 100 years old.  Developed by Bayer Chemical, the same year as they developed Heroin, they would both go on to have famous careers.  Actually, Bayer thought Heroin would be much more popular….little did they know.

Aspirin remains a great medication for a whole host of issues, but among the most important is it’s ability to prevent colon cancer.  This has been demonstrated in multiple studies and is among the reasons daily aspirin remains legitimate, despite the controversy about it’s ability to prevent vascular issues.

Now, studies are identifying the benefits of aspirin for colon prevention is related to specific genetic modifications in the colon polyps and tumors.  These studies show that if a person with colon cancer has their tumor analyzed, and they find a specific mutation called PIK3CA, then aspirin provides an 80% reduction in cancer recurrence.  Great news for these people, but patients with other mutations do not get much, if any, benefit from aspirin use

Read more:

http://www.nejm.org/doi/full/10.1056/NEJMoa1207756

ASPIRIN PREVENTS PROSTATE CANCER RECURRENCE

A recent study of 6000 men with localized prostate cancer demonstrated a marked reduction in cancer recurrence with the use of aspirin.    A 57% reduction in recurrence was noted.

This simple measure is worth employing in anyone with a history of prostate cancer, so tell someone you know who has had either surgery or xray treatment for their disease.

http://jco.ascopubs.org/content/early/2012/08/26/JCO.2011.41.0308.abstract

IN THE BIG PICTURE….ASPIRIN HELPS PREVENT CANCER

A new study of 100,000 patients shows a small, but significant reduction in cancer in patients who take daily aspirin.
There was a 16% reduction in aspirin-takers…..mostly affecting colon and intestinal tract cancers, liver cancer, and bladder cancer.
This benefit is statistically small, but fits in with the larger picture for aspirin as a beneficial agent in reducing inflammation and intervening with cancer cell development and propogation.
Aspirin is celebrating it’s 100th anniversary of production by Bayer, inc…..and was released the same year as Bayer’s other expected blockbuster…….Herion (that part of the story didn’t turn out as well!)
Read more about this study and it’s importance here, in the JNCI:
http://jnci.oxfordjournals.org/content/early/2012/08/10/jnci.djs338.full

MORE POSITIVE DATA IN FAVOR OF ASPIRIN FOR COLON CANCER

This week’s Lancet Journal (from England) has an important study supporting the use of aspirin in preventing colon cancer.
Aspirin at 600mg daily (equivalent of 2 full dose pills) yielded a significant reduction in colon cancers in patients with Lynch Syndrome (a genetic predisposition to colon cancer). Although not clearly applicable to other patients with polyps or sporadic cases of colon cancer, it is good evidence to support the possibility that such patients would benefit.
Combining the heart and stroke prevention abilities of aspirin with the colon cancer data provides more support for use of aspirin as a general preventive in adults.