Welcome to another edition of the Doctor’s Note where we talk about what’s on our minds when it comes to your health.
In today’s fast-paced world, there’s a whirlwind of information surrounding daily use of aspirin, leaving many people confused and misinformed. That’s why on this week’s podcast I wanted to revisit this tiny, yet mighty, 81 mg pill that’s been a part of my daily regimen for the past 30 years.
Is it really the miracle drug it’s often touted to be, or are there risks we need to consider? This week we will dive deep into the history, benefits, and controversies of daily aspirin use. From its ancient origins to its modern applications in preventing heart disease, stroke, and even cancer, let’s explore why aspirin is worth a second look. Whether you’re skeptical or a believer, join me as we unpack the science and common sense behind this everyday medication.
PODCAST NOTES
Aspirin has a rich history dating back nearly 4000 years. Ancient civilizations such as the Greeks and Romans utilized willow bark, the natural source of aspirin, for its antipyretic (fever reducing) and analgesic (pain relieving) properties. This highlights its long-standing efficacy and relevance in medicine.
Contemporary guidelines have evolved, creating some confusion. In 2022, the United States Preventive Task Force updated their recommendations, suggesting aspirin mainly for secondary prevention of heart disease and stroke in individuals aged 60-69. This marks a departure from prior endorsements that supported aspirin for primary prevention, that is, to prevent diseases before they occur.
Aspirin’s dual functionality as an anti-inflammatory agent and anticoagulant makes it particularly valuable. It works by reducing inflammation and preventing blood clots through platelet inhibition. This dual action is one reason for its widespread use in cardiovascular health.
In this episode, I emphasized aspirin’s potential in reducing the risk of various cancers, most notably colon, colorectal, and other gastrointestinal cancers. Consistent intake of an 81 mg dose has been linked to a 35% to 50% reduction in cancer risk. Aspirin’s inhibition of inflammatory enzymes (COX-1 and COX-2) likely plays a role in this protective effect.
One of the main reasons for the controversial guidelines is aspirin’s association with an increased risk of bleeding, including gastrointestinal (GI) bleeds and hemorrhagic strokes. Higher doses are generally more problematic, making the 81 mg dose a safer choice under medical guidance. Notably some studies have shown fewer fatal GI bleeds among aspirin users compared to those on placebo.
I recommend supplementary diagnostic tools like the CT Calcium Score and CIMT (Carotid Intimal Media Thickness). These tests provide a more nuanced understanding of arterial health and atherosclerosis, aiding in more personalized cardiovascular risk assessments.
Aspirin is highly effective in preventing myocardial infarctions (MIs) and ischemic strokes. However, it is less effective for preventing strokes in patients with atrial fibrillation (AFib), where newer anticoagulants like Xarelto and Eliquis, which better inhibit thrombin and prevent larger clots, are favored.
During a heart attack, chewing a 325 mg aspirin can be life-saving by rapidly reducing clot formation. Keep aspirin accessible at home and while traveling to address such emergencies promptly, potentially stabilizing the patient until professional medical help arrives.
For me, my commitment to a daily 81 mg aspirin regimen is grounded in both extensive research and personal conviction. The potential benefits for heart health, clot prevention, and cancer reduction outweigh the risks for many, though individual factors must always be taken into account. Remember, this is a highly personalized decision that should be made with a well-informed doctor. As I approach 70, I remain unwavering in my choice, believing it to be a great preventive strategy for longevity.
Do your own research. Stay educated. Stay healthy.
Till next week.
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