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Aspirin a Day?
It seems we get different advice about aspirin every year. Aspirin is one of the oldest substances continuously used as a medication. It's is in a class of drugs called "Non-Steroidal Anti-Inflammatories" (NSAIDs) and it blocks the production of a chemical called prostaglandin. Blocking prostaglandin is how aspirin confers its benefits (relieving pain, reducing fever, decreasing inflammation and thinning blood) but also how it causes harm (inflaming the stomach lining resulting in ulcers, thinning blood enough to cause excessive bleeding). Currently, aspirin is widely used because it can prevent clot formation which is a major player in heart attacks and strokes.
The decision whether or not to take a daily aspirin needs to be individualized. It's generally thought that if you have had a heart attack or stroke, the risk of having another one is so high that the anti-clotting benefit of aspirin outweighs the excessive bleeding risks. The question is whether daily aspirin can prevent your first heart attack or stroke without causing harm. The U.S. Preventive Services Task Force (USPSTF) has researched and published evidence based guidelines for this. The result is that aspirin helps prevent heart attacks in some men between the ages of 45-80 and helps prevent strokes in some women between 55-80. The USPSTF has links to personal risk calculators, and your doctor can also help estimate your risks. Prevention of these deaths requires many actions not just adding a daily aspirin --lowering cholesterol and blood pressure, smoking cessation-- but I thought it was a good evidence based reminder for each of us and our loved ones.