Should I take an aspirin to prevent a heart attack?
When did aspirin start being used to prevent heart attacks?
There is evidence that the compound in aspirin was used thousands of years ago by the ancient Sumerians and Egyptians. The first study on aspirin occurred in 1758 where dried bark from the English Willow tree was used to treat the symptoms of Malaria.
Is that why you have a picture of Willow trees on the page?
Yes.
Nothing get’s by me. Okay, go on.
The first publication on aspirin in 1876 showed it’s usefulness in reducing fevers and joint pain. The process to make Aspirin was patented by the Bayer pharmaceutical company in the 1890’s and in the early 1950’s was the most common pain killer in the world.
Are you a politician? You didn’t answer my question. How did aspirin come to be used to prevent heart attacks?
Right. For that we need to thank a family practice doctor in Glendale, California named Lawrence Craven. Dr. Craven did tonsillectomies and began to give his patients gum containing aspirin prior to the procedure. Several of the people were hospitalized because of bleeding after the procedure. He realized that aspirin stopped blood from clotting. He thought that if heart attacks are caused by blood clots (they are!), that if he gave his patients aspirin, they wouldn’t have a heart attack. He gave 400 patients aspirin, and over 2 years, none of them had a heart attack. He wound up giving 8,000 total patients aspirin and just prior to his death wrote that not one of them had suffered a heart attack or stroke. He recommended that anyone between 45-65 years old, take aspirin. Ironically, Dr. Craven died of a heart attack.
He died of a heart attack? So did taking aspirin become common place after that?
Not quite then. He published his findings in obscure medical journals. Other researchers proved scientifically how aspirin stops our bodies from forming blood clots, and the first modern study on aspirin and heart disease was done in 1973. It showed that people who took aspirin had a lower chance of a heart attack, but the results weren’t that convincing. In the 1980’s all aspirin studies were reviewed and doctors felt like it actually worked.
The 1980’s were so long ago–like back when they had cassette tapes and VCR’s. What have we learned since then?
We’ve learned four things. One, aspirin does prevent heart attacks. Two, if you’ve had a heart attack, have a cardiac stent, or had bypass surgery, you ABSOLUTELY SHOULD take an aspirin. Three, the dose of aspirin should be the “baby” aspirin of 81mg. The fourth is that only a select group of people without heart disease should take aspirin daily. Today, about 40% of adults over 50 years old take a daily aspirin, but many of those people have just decided on their own to take aspirin. The decision to take aspirin should be based on 3 things:
1). Your age
2). Your bleeding risk
3). Your risk of a heart attack over the next 10 years
All these numbers made me remember a math joke. Did you know that there are three types of people in this world? Those who can count, and those who can’t.
I’ll pretend that didn’t just happen.
So how old should I be to go on aspirin?
If you’re between the ages of 50-69 years old there’s some science to suggest that aspirin my help you. If you’re older or younger than that, theres not enough science to say that aspirin will help you or hurt you.
Hurt you? How can aspirin hurt you. I thought it was a pain killer?
Aspirin does two main things besides reduce pain from inflammation. It decreases clotting of our blood vessels and it lowers the production of the protective layer of our stomach. People who take aspirin daily increase their risk of stomach bleeding or worse—getting a brain bleed (hemorrhagic stroke).
Is this the knowing your bleeding risk part?
Yes. If you have had ulcers, have untreated high blood pressure, or are taking other blood thinners, you may want to think twice about taking an aspirin. It’s been shown that people with ulcers are 2-3 times more likely to have bleeding from aspirin than other people.
Okay, so what’s the 10 year risk thing?
Aspirin is recommended for people aged 50-69 years, who have a risk of heart disease >10% over the next 10 years. You can calculate your 10 year risk of heart disease here.
So, let me get this straight, if I’m between 50-69 years and my 10 year risk of heart disease is less than 10%, I probably shouldn’t take an aspirin?
Bingo. Certainly there are exceptions–that’s why we have doctors.
So how good is aspirin at preventing heart attacks?
It’s okay. But here’s something that you need to know. Across the board, aspirin will cause more stomach or brain bleeds than it will prevent heart attacks.
What?! Than why would you take a daily aspirin?
Here’s how you have to look at it the benefits of aspirin. Aspirin ALSO prevents strokes and colorectal cancer. Here’s the science: 1 in every 22 MEN who take aspirin over their lifetime will prevent a heart attack, stroke, or colon cancer. But 1 in every 35 MEN who take aspirin will have a serious stomach or brain bleed causing either a hospitalization or death. In women the benefit is about 1 in every 23, and the harm is about 1 in every 43.
I’ll be honest. The bad stuff with aspirin is pretty high.
Yep. That’s why it’s not recommended for everyone. Between 60-69, the benefit to risk ratio is even a little worse. In men that old, about 1 in 28 benefit, while 1 in 32 are harmed. In women, about 1 in 30 benefit, while 1 in 39 are harmed. Furthermore, people have to take aspirin for 5 years before they start to have the protection from heart attacks, and 10 years before they have the protection from colon cancer.
Do you take aspirin Dr. Lugnut?
No. I’m the VCR/Casette tape generation, not the beta tapes and 8 track generation. I probably won’t though–my 10 year risk of a heart attack is <10%.
What’s an 8-track?
Enjoy the video below. You won’t even have to rewind.
Dr. ________,
You just told me about this website this morining. I have reviewed it and I find it immensely informative and entertaining! Thank you for suggesting it. I cannot stand Avocadoes but I plan to develop a taste for them. Lots of the other things you recommend I am already doing (smug smile) but I need to adopt some other practices. See you in a year.
Thanks for the feedback. There are many other foods that contain the same good fats as avocados. If you do gain a taste for them, maybe we could split some guacamole next year!