If you have not had a heart attack
One – You’re in your 50s. The Medical Publication, Health After 50, reports that a panel of experts has updated the guidelines for taking Aspirin at various ages. It says you, in your 50s, have a 10 per cent or greater risk of coronary attack or stroke in the next 10 years, and a life expectancy of at least 10 years with no increased risk of gastrointestinal (GI) bleeding. If you meet one of these requirements it says you may be a candidate for a daily baby Aspirin (81 milligrams). You can calculate your risk of heart attack at www.cvriskcalculator.
Two – You’re in your 60s. In this case, the publication says you have a high risk of heart attack or stroke over the next 10 years and a life expectancy of at least 10 years with no increased risk of GI bleeding. If you meet one of the these requirements you must then be prepared to take a daily 81 mg. Aspirin for 10 years which is the minimum required for benefits to take effect.
Three - You’re 70 years of age or older, or younger than 50. Here, experts say there’s not enough evidence to advise one way or the other in preventing either a first heart attack or colon cancer. But it adds that, since many over the age of 70 have health problems, the risk of heart attack or stroke may be increased. Then the benefits of a daily Aspirin may be substantial.
If you have had a heart attack
Four - People who have already had a heart attack, stroke or other forms of cardio-vascular disease (CVD) should take a baby aspirin to decrease the risk of a second heart attack, stroke or dying from CVD.
Five – As you may have guessed by this point, the big risk is that small doses of Aspirin can trigger GI bleeding. In Canada about 2,000 people die from this problem each year and about 22,000 in the U.S. You are at increased risk if you are over age 65 and a male. Or if you have a history of peptic ulcer, hypertension, take blood thinners or corticosteroids, doses of nonsteroidal anti-inflammatory drugs, have a low platelet count, liver or kidney disease.
Six – Some say you can decrease the risk of GI bleeding by taking a low dose enteric-coated baby Aspirin. But other authorities say there’s no scientific evidence that this low dose suggestion or a buffered Aspirin decrease the risk of GI bleeding. One should also limit the amount of alcohol and not take painkillers such as Motrin, Advil and Aleve along with Aspirin unless advised by your doctor. It’s also important to take Aspirin with water and food, not on an empty stomach. And do not stop Aspirin abruptly as this may cause a rebound effect increasing the risk of heart attack and blood clot.
Seven – Make sure you always discuss the pros and cons of Aspirin therapy with your doctor. Remember the sage advice that he who treats himself or herself has a fool for a patient!
Eight - Readers know that I do not like long-term medication. But there are exceptions to every rule and I have been taking a baby Aspirin for 20 years after a coronary attack. I also take high doses of Vitamin C to decrease risk of another heart attack.
Nine – Interestingly, I have found no mention of the use of Aspirin for those suffering from diabetes. But researchers at the Center for Disease Control in Atlanta report that 98 per cent of diabetes patients should be taking Aspirin and only 20 per cent are doing so. This advice makes sense since these patients suffer from varying degrees of atherosclerosis (hardening of arteries) and have a 50 percent chance of dying of heart attack.
Ten – It is also ironic that one study showed 51 per cent of heart attack victims were not taking Aspirin. In fact, seven percent were taking Tylenol which is not effective in preventing blood clots!
This column is not meant to diagnose or treat medical problems so always see your own doctor.