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Daily Aspirin: Is it right for you?

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Tuesday, July 20, 2010

Daily Aspirin: Is it right for you?

I heard a few of the hens on the beach the other day, and they were chit chatting about their health, their friends health, and they were giving each other medical advise.  The best advise, you ask?  It goes a little like this: " well my cardiologist told me not to take a daily aspirin, but my primary doctor did" so the middle hen replies " oh, well you should definitely take it, I am certain of that, because I take one. A friend of mine had a stroke, so I just started; didn't even ask my doctor."  Sometimes its really hard not to jump in, but I listened, and thought about how horrible that advise was, and how people clearly don't understand why taking a daily aspirin can be good for you and why it is better for certain groups of people.  

How does Aspirin work?
Aspirin works by affecting the platelets in the blood.  When any sort of injury occurs to blood vessels, platelets rush to the scene to form a plug to seal any hole in the vessel wall then stop the bleeding.  This clotting can effect all major blood vessels in your body.  If your blood vessels are already narrowed from atherosclerosis (a build up of fat in your arteries) those fatty deposits can burst, a blood clot can form, and that clot can go to your brain or heart and cause either a stroke or heart attack.  Aspirin reduces the clumping nature of platelets, to decrease the risk of these clots to prevent a heart attack or stroke.  

The difference in therapy between men and women:
In Men, aspirin tends to prevent a first and second heart attack and decrease heart disease risks.  For women UNDER 65, it prevents a first stroke, second heart attack, and decrease heart disease risk.  And for women OLDER than 65, it can prevent a first and second heart attack, first stroke, and decrease heart disease risk. 

Who should be taking Aspirin therapy?
It really depends on your risk of heart attack and stroke.  If you have any of the following, then daily aspirin may be appropriate therapy for you:

Smoking tobacco
High blood pressure — a systolic pressure of 140 millimeters of mercury (mm Hg) or higher or a diastolic pressure of 90 mm Hg or higher
Total cholesterol level of 240 milligrams per deciliter (mg/dL) — 6.22 millimoles per liter (mmol/L) — or higher
Low-density lipoprotein ("bad") cholesterol level of 130 mg/dL (3.37 mmol/L) or higher
Lack of exercise
Diabetes
Stress
Having more than two alcoholic drinks a day for men, one drink a day for women
Family history of a stroke or heart attack
If you have had a stroke or heart attack, then you probably should be on aspirin therapy, and, as I stated before, if you have some of these risk factors, you should talk to your doctor about starting aspirin therapy.

Is there a difference?
I know that it can also be confusing that some people are on 81mg (baby aspirin) whereas other people take 325mg (i.e. one Bayer Aspirin) and it is completely based on your past medical history and your risk factors, and your docotor will make that decision for you...and you may switch therapies at some point based on your bodies reaction to the aspirin. 

Who should AVOID daily aspirin therapy?
If you have:
Asthma, bleeding/clotting disorder, stomach ulcers, heart failure.  

the American Diabetes Association recommends that diabetics only take low dose (baby) aspirin therapy.  Also, if you take ibuprofen frequently you should tell your HCP because that can out you at risk for increased bleeding.  And, if you are on ANY blood thinners including heparin or coumadin (warfarin) you should NOT be taking aspirin (your HCP should discuss with you what you can and cannot take on those drugs)

What are possible side effects of daily aspirin therapy?

Hemorrhagic stroke. While daily aspirin can help prevent a clot-related stroke, it may increase your risk of a bleeding stroke (hemorrhagic stroke).
Gastrointestinal bleeding. Daily aspirin use increases your risk of developing a stomach ulcer. And, if you have a bleeding ulcer, taking aspirin will cause it to bleed more, perhaps to a life-threatening extent, so you may be put on another medication (protonix/pantoprazole) to prevent this
Allergic reaction. If you're allergic to aspirin, taking any amount of aspirin can trigger a serious allergic reaction.
Ringing in the ears (tinnitus) and hearing loss. Too much aspirin (overdosing) can cause tinnitus and eventual hearing loss in some people.
Also, you should limit the amount of ibuprofen and alcohol that you ingest because it can cause these issues due to over thinning of the blood.  

Hopefully this clears up questions surrounding aspirin therapy so that people realize its not as cut and dry as your friend telling you to take it because her friend had a stroke lol!!!  On the other hand, if you have a loved one that you think may b at risk that doesn't necessarily go to their HCP regularly (yeah, I know a few of those!) maybe suggest that they discuss at their next visit.

Yours in Good Health

B


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