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Aspirin & Heart Disease
20 Jan 2020
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Is aspirin helpful for "primary prevention" or "secondary prevention" of heart disease?
NIH Guidelines

(2019) Aspirin use may be widespread despite new guidelines by NIH (National Institutes of Health, USA). This article asks the public to become more aware of pros and cons of daily aspirin (for details of pros and cons, see Dr Greger's video and article below). The article reminds us:

"Nationwide, about 29 million people who don't have cardiovascular disease take aspirin daily for prevention — and 6.6 million do so without a health care provider recommendation."

Dr Greger

Articles by Dr Greger:

  • (2019) The Risks and Benefits of Taking Low-Dose Aspirin

    Is aspirin helpful for Secondary Prevention? Excerpts from the above article:

    "The bleeding complications associated with aspirin use may be considered an underestimated hazard in clinical medical practice. For those who have already had a heart attack, the risk-benefit analysis is clear. If we took 10,000 patients, daily low-dose aspirin use would be expected to prevent approximately 250 "major vascular events," such as heart attacks, strokes, or, the most major event of all, death. However, that same aspirin "would be expected to cause approximately 40 major extracranial bleeding events," meaning bleeding so severe you have to be hospitalized. Thus, the net benefit of aspirin for secondary prevention -- for example, preventing your second heart attack -- "would substantially exceed the bleeding hazard. For every 6 major vascular events prevented, approximately 1 major bleeding event would occur; therefore, the value of aspirin for secondary prevention is not disputed.

    Is aspirin helpful for Primary Prevention? Excerpts from the above article:

    "If we instead took 10,000 patients who hadn't ever had a heart attack or stroke and tried to use aspirin to prevent clots in the first place, that is, for so-called primary prevention, daily low-dose aspirin would only "be expected to prevent 7 major vascular events and cause 1 hemorrhagic stroke [bleeding within the brain] and 3 major extracranial bleeding events." So, the benefits are approximately only 2 to 1, which is a little too close for comfort. This is why the new European guidelines do not recommend aspirin for the general population, especially given the additional risk of aspirin causing smaller bleeds within the brain as well."

Videos by Dr Greger:

(2021) Should We All Take Aspirin to Prevent Heart Disease?

(5 mins) Transcript. Dr Greger's summary: "The benefits of taking a daily aspirin must be weighed against the risk of internal bleeding."

Natural Sources of Aspirin?

In Dec 2020, I learnt of the Aspirin & Cancer connection! This article explains which foods have naturally occuring aspirin: cumin seeds, for example!

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