Tuesday July 16, 2013
It's been a while (maybe forever?) since we talked about aspirin. Now seems like a good time. This also highlights one of the improvements in our website...now all these blast email articles I send to you will be in the 'library' on our/my website at www.firstlinephc.com Let's cut to the chase...the following things I believe to be true regarding aspirin... (1) aspirin reduces the likelihood of 2nd heart attacks...while no proof exists (hard to set up such a study), the inference is it reduces the likelihood of 1st heart attacks ... I hope so (2) aspirin reduces the risk of colon cancer (how? I have NO idea); it also seems to reduce the likelihood of other cancers: esophageal, stomach and, perhaps, lung (the data is truly incomplete there) (3) aspirin reduces the likelihood of distant metastasis in those who did get cancer (4) aspirin does INCREASE the risk of cerebrovascular hemorrhage, but this increase in risk is offset by the reduction aspirin produces in thrombotic stroke...in other words, aspirin prevents more clots than it causes bleeds OK, well, you say, what dose should we take? Aaaah, well, it depends upon whom you believe. The cardiologists say 81 mg a day. The neurologists say 325 mg twice a day. I say, I don't know, but somewhere between 81 - 325 mg daily. I think you should get aspirin (ASA for short) that is enteric - coated, i.e., designed not to let the ASA eat away your stomach lining. I guess. One of my colleagues, a gastroenterologist, called me after a case one time to tell me my patient had a slowly dissolving enteric - coated aspirin at the base of his bleeding ulcer in his stomach. Nonetheless, I still use enteric - coating. Well, that's my story (for now) and I'm sticking to it...