KarlT
#41
It would be best to discuss this with your Cardiologist.
I don’t know your age and that would impact your decision.
There is no clear guidance for the use of daily baby aspirin in people that have not had a prior heart attack. You have to decide if the benefit of preventing a heart attack outweighs the risk of bleeding. Both risk and benefit are very small. About 1% different than someone not taking aspirin. The older you get the higher the risk of bleeding.
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Read desertshores’ post # 10 in the thread below.
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Beth
#43
I’m quite confused about it, but you just said something meaningful, which is the benefit might only be tiny.
I’m almost 59.
Years ago, an excellent cardiologist advised me to take one 3x per week. I’ve been doing that for years. But, recently, on here, I read that if one has heart disease, a daily baby aspirin is recommended. That same week, my older sister’s new cardiologist also told her to take one daily. (Her situation is similar to mine, although not quite as bad).
I assumed the science must have changed, so I emailed my cardiologist, as you also suggested, and he simply said it will have no effect one way or the other, so take it if you want or not. I had never heard this before and assumed he must be wrong which is why I was inspired to hear from all of you.
He had recently told me not to take vit k with calcium because vit k can cause lung cancer (or something like that). I’ve never heard that either so I wasn’t too keen on taking his aspirin advice at face value.
I guess I also need to learn more about the bleeding and how serious that is. I don’t know much about it.
@JuanDaw thanks for this. I’ll read this over tomorrow morning to try to absorb it. I might be back with questions. Unfortunately I only understand science at a very surface level!
The link above is to the thread. Desertshores’ post 10 is quoted below for easy reference.
" The main benefits I have found reading some of the literature regarding low-dose aspirin.
Reduces risk of heart attack in those with heart disease
Reduces risk of ischemic stroke
May reduce the risk of colorectal cancer
The literature about the benefits of low-dose aspirin is a mixed bag, but I will continue taking it for the possible colon cancer prevention properties. I find the risk small.
“GI bleeding with low-dose aspirin versus placebo is approximately 0.12% per year, or 1.2 extra cases per 1000 patients treated per year”
PubMed 中心 (PMC)
Low-dose aspirin has proven effectiveness in secondary and primary prevention of cardiovascular events, but is also associated with an increased risk of major bleeding events. For primary prevention, this absolute risk must be carefully weighed…
“The absolute annual increase in major GI bleeding attributable to low-dose aspirin versus placebo is around 0.12% (95% CI: 0.07-0.19%) based on a meta-analysis”
考研
Low-dose aspirin increases the risk of major bleeding by approximately 70%, but the absolute increase is modest: 769 patients (95% CI, 500-1250) need to be treated with aspirin to cause one additional major bleeding episode annually. Compared with…
考研
The current study demonstrated that the cardiovascular benefits of low-dose aspirin were equally balanced by major bleeding events. In addition, the potential beneficial effects might be seen in the population ≤ 70 years of age with high…
考研
The USPSTF recommends initiating low-dose aspirin use for the primary prevention of CVD and 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…
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At my most recent annual exam, my doctor pointed out that I could take low dose aspirin every other day rather than daily due to the 1/2 life. (I am not taking aspirin for any primary intervention, just because I think it good for a number of reasons - including prostrate health). So I have been doing every other day recently, and filling-in the non-aspirin days with a willow bark supplement. The idea to mitigate stomach/brain bleeding risk. Frankly I think the risk from aspirin is possibly so over-stated as to be stupid to promote, other than in specific cases.
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KarlT
#46
Interesting. The data I have seen shows a 2% increased risk of bleeding in patients with risk of heart disease. Higher in older people such that it is not recommended in the over 60 age group.
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Beth
#47
Can you share more details about your dosage of willow bark, please? I was curious if there was anything to do to help mitigate our chances.
@KarlT, my sister is 64 and her cardiologist recommended she have a daily aspirin based on her CAC of in the 300s. But yeah, mine said whatever… so it’s hard to know what to do out there!
@JuanDaw thanks for all these links and more info. I’m going to start reading now!! I really appreciate it. At first glance, as you included, it seems that I probably should have it based on my 10 year cvd risk. I’m sure I’ll be back soon to ask you all to interpret the data for me 
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Just FYI, I was taking a 325mg aspirin about 2-3 days a week with fish oil (SPM effect). I started having acid reflux which I have had in the past. It went away a week after stopping the aspirin. I do intend to try again with a 81mg at some point.
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jakexb
#49
This is definitely one of those where you have consider individual factors. My mom has be showing signs of decreased microciruculation (retina issues, white matter hyper intensities on MRI) and in that context, her doctors have put her on daily low dose aspirin.
Now it sounds like if your microcirculation is already normal, it’s not worth the increased risk of bleeding.
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Beth
#50
Wanted to share how my story ends!
I’m very appreciative for the advice and links and all around support on this!
After reading everything provided, I had a long talk with my internist. I shared what I learned here and what my cardiologist advised (the ‘taking it won’t help much’ advice).
His first action plan is for me to never talk to that cardiologist again :). He said just because they are UCSF does not mean they are good.
Based on my elevated risk, he feels I should take one every day, especially due to having a ‘young’ healthy brain. I asked if there is an age I should stop due to the risk of a brain bleed, he said even if I get a disease that increases my chance of a fall, he’d still have me continue due to my larger heart risk relative to my falling brain bleed risk.
He said all I need to do to drastically reduce the risk of a GI bleed, which is small to begin with, is to take it with food. EUREKA!! How have I never heard this simple advice before!!???
Interestingly, he recommends a NON buffered (non enteric coated) baby aspirin!! He said that should be better absorbed. If anyone has thoughts on this one, do chime in. I guess this is why they say chew aspirin if having a heart attack!
Thank you again!!!
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Bingo. That’s what I was looking for. Thanks.
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Yes, the non enteric coated have a better bioavailability. Don’t know why a few Dr still prescribe the enteric coated one for low doses like 81mg.
Better to take a chewable one with a meal.
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Beth
#53
Look at you, the keeper of all the knowledge !!!
I’m afraid to ask this dumb question, but I have no shame, so…
I can just swallow the chewable aspirin, correct? I remember from my childhood I hate that orange flavor
EDIT:
I at least found cherry flavor! Definite upgrade from my PTSD orange
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KarlT
#54
Yes, you can swallow the chewable. Thanks for giving us follow up.
Generally speaking, physicians recommending aspirin should be recommending baby aspirin which is the chewable. Enteric coated will still work, just maybe not as well.
Mechanism of action: Aspirin (ASA), prevents platelets from sticking together and forming a clot. This is a permanent effect for the life of the platelet. Platelets only have a life of 7-10 days, so everyday 10-15% of your platelets are replaced. Thus, if you don’t take aspirin daily then 10-15% of your platelets can still form clots. Btw, Ibuprofen also blocks platelets from clotting but not permanently, only for 24ish hours.
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New paper in Nature (open access): Aspirin prevents metastasis by limiting platelet TXA2 suppression of T cell immunity
Discussion
Here we show that platelet-derived TXA 2 functions as a potent
immunoregulatory molecule that suppresses T cell immunity to
cancer metastasis by inducing the immunosuppressive function of
ARHGEF1. Consequently, COX-1 inhibition, including using aspirin,
enhances anti-metastatic immunity by releasing T cells from TXA2–
ARHGEF1-mediated suppression (Extended Data Fig. 14). These findings
add to our mechanistic understanding of the observed anti-metastatic
effects of aspirin.
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Hi John, would you mind please expanding on this? Why are you concerned about reducing prostaglandin production?
As a general principal i wish to keep the body functioning normally apart from the age based deterioration. I find stopping prostaglandins cauaes sleep issues. There is some research also linking prostaglandins to kongevity
Jonas
#58
Prostaglandins can promote tumor growth by enhancing cell proliferation and angiogenesis, so dose is the key?
Jonas
#59
Two tibits based on a podcast a few months ago:
- David Sinclair is still taking 81mg of aspirin most days.
- He is on weekly low-dose rapamycin.
- He has a new book coming out.
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I am not suggesting exogenous prostaglandins. They are signalling molecules, but operate within the cell.
I take the view that switching off autocrine signalling or moreso reducing it in a generic manner is not good. Aspirin disrupts my sleep. That is a known side effect.
