WASHINGTON — Millions of people who take aspirin to prevent a heart attack may need to rethink the pill-popping, Harvard researchers reported Monday.

A daily low-dose aspirin is recommended for people who have already had a heart attack or stroke and for those diagnosed with heart disease. But for the otherwise healthy, that advice has been overturned.

Guidelines released this year ruled out routine aspirin use for many older adults who don’t already have heart disease — and said it’s only for certain younger people under doctor’s orders.

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How many people need to get that message?

Some 29 million people 40 and older were taking an aspirin a day despite having no known heart disease in 2017, the latest data available, according to a new study from Harvard and Beth Israel Deaconess Medical Center. About 6.6 million of them were doing so on their own — a doctor never recommended it.

And nearly half of people over 70 who don’t have heart disease — estimated at about 10 million — were taking daily aspirin for prevention, the researchers reported in Annals of Internal Medicine.

“Many patients are confused about this,” said Dr. Colin O’Brien, a senior internal medicine resident at Beth Israel who led the study.

After all, for years doctors urged people to leverage aspirin’s blood-thinning properties to lower the chances of a first heart attack or stroke. Then last year, three surprising new studies challenged that dogma. Those studies were some of the largest and longest to test aspirin in people at low and moderate risk of a heart attack, and found only marginal benefit if any, especially for older adults. Yet the aspirin users experienced markedly more digestive-tract bleeding, along with some other side effects.

In March, those findings prompted a change in guidelines from the American Heart Association and American College of Cardiology:

— People over 70 who don’t have heart disease — or are younger but at increased risk of bleeding — should avoid daily aspirin for prevention.
— Only certain 40- to 70-year-olds who don’t already have heart disease are at high enough risk to warrant 75 to 100 milligrams of aspirin daily, and that’s for a doctor to decide.

Nothing has changed for heart attack survivors: Aspirin still is recommended for them.

But there’s no way to know how many otherwise healthy people got the word about the changed recommendations.

“We hope that more primary care doctors will talk to their patients about aspirin use, and more patients will raise this with their doctors,” O’Brien said.

— Lauran Neergaard
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The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute’s Department of Science Education. The AP is solely responsible for all content.

 

 

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  • I tried taking extra strength Tylenol for a chronic pain issue. After approximately three or four weeks I broke out in an extremely bad rash that was so itchy that it made me scratch the areas especially during the night. It is healing now, after stopping the otc drug, and the itching has subsided too. I was especially concerned about having an outbreak of shingles, except for the fact that I was not in excruciating pain, which is the condition that everyone who has had shingles is typically experiencing. After giving some thought to my condition I decided to stop the latest otc medication first. I kept the area that was on the lower right leg clean with Neosporin and then changed to using cortisone with a large surgical bandaged pad and used a soft medical tape to hold the large bandage in place. It took me about two weeks before I could stop using the otc cortisone, and to be able to not have to use everything anymore. It was manifest in my scalp too, and at night I wore gloves to prevent me from scratching myself in my sleep.

    I learned a lesson from this experience, and that was to call my personal physician, should I ever again try anything myself first. It’s why we have had an excellent physician we found, with asking for our own health care issues that took us a while before we finally found an excellent physician, whom I should have gone to see, with the initial decision to do all of this myself. I didn’t do any serious harm, but I was fortunate enough to at the least to know what to do to care for myself. Something that I could have probably avoided if I had gone to see him from the beginning of the this self made decision to take anything from the beginning, and I could have avoided my concerns with his guidance. Yes I am a yutz for attempting to take a medication that I am obviously unable to use for myself. The point is that I have an excellent physician who could have spared this from happening to me in the first place. An excellent lesson for everyone who is going to make decisions for a condition that he would have known to discern what I might have done differently for the added pain and then to add even more pain that I could have avoided by going to him from the start.

    An excellent article about this situation that I wish I had read before I did what I did without the help from my physician.

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