Aspirin may prevent a heart attack, but is it worth the risk of internal bleeding? Not for some people.

Currently, an independent committee of preventive experts states that adults over the age of 60 should not start low-dose aspirin therapy to avoid heart disease.

Aspirin can cause internal bleeding in or around the gastric and intestinal systems, US Preventive Medicine Expert Committee Reported with recommendations published on Tuesday, April 26..

Dr. Akshay Kandelwar, an intervention cardiologist at Detroit-based Henry Ford Health, said on Wednesday, “Prevents heart attacks and strokes, but causes more serious bleeding, and sometimes it. It even causes fatal bleeding that outweighs its benefits. ” 27.

The risk of bleeding increases with age, as does the risk of heart disease.

As quantified by the estimator, the decision to take aspirin should be an individual decision if the risk of cardiovascular disease is 10% or higher in 40-59 individuals over the next 10 years. “

This guidance does not apply to anyone who has already experienced at least one heart attack, stroke, or vascular event, Khandelwal emphasized several times.

For them, the benefits outweigh the risks. This group is automatically placed in high-risk groups, Kandelwar said.

He said they had received coronary, carotid, or vascular stents and could have been used to open occluded passages and need to take aspirin or antiplatelet drugs.

Aspirin can relieve fever and pain and reduce inflammation. Decades ago, platelets were found to be antiplatelet agents that prevent cells in the blood from forming blood clots, Kandelwar said.

There is growing awareness of aspirin-related complications, according to Kandelwar. He said similar recommendations were made by the American College of Cardiology and the American College of Cardiology.

“Many of us started reading the literature and drastically reduced the primary prescriptions for aspirin.”

He said there are, if not more effective, ways to prevent heart disease.

Cholesterol-lowering medications can help as well as lifestyle changes such as diet and exercise planning. The Heart Association recommends a total of 150 minutes of moderate intensity exercise per week. A Mediterranean diet helps reduce the likelihood of a heart attack or other related problem with a healthy fat and whole grain, or vegan plan. ..

For example, quitting smoking can bring far greater benefits than starting to take aspirin.

Physicians have uncontrolled diabetes, despite optimization of insulin and other treatments, bleeding and other medical problems and risk factors, such as optimization of insulin and other treatments. Or Khandelwal said he might consider aspirin for 40-59 patients with a low risk of uncontrolled lipids despite optimization of drug therapy. These patients may have a high coronary calcium score, which is a measure of coronary calcified plaque.

According to the Task Force, people at low risk of bleeding have no history of gastrointestinal ulcers, recent bleeding, or other medical conditions, or are using drugs such as nonsteroidal anti-inflammatory drugs, steroids, and anticoagulants. The risk is high.

The Task Force reported that the benefits of starting aspirin use are greater for people at high risk of cardiovascular events.

We analyzed 11 trials and showed that the use of low doses of aspirin was associated with a statistically significant reduction in the risk of non-fatal heart attack. Studies in five trials have shown that aspirin is associated with a reduction in non-fatal ischemic stroke that occurs when blood supply to parts of the brain is interrupted or diminished.

Looking at the studies reporting the harm of low-dose aspirin use, a pooled analysis of 10 trials showed that aspirin use was associated with a 58% increase in major gastrointestinal bleeding. Examination of 11 trials showed increased intracranial or intracranial hemorrhage in the aspirin group compared to the control group.

Cardiovascular disease is the leading cause of death in both men and women in the United States. According to the Task Force, increased mortality from cardiovascular disease has been reported in recent years.

In Michigan, heart disease was the number one cause of death in 2020 and the most recent year for which information was available. More than 27,000 people have died. In comparison, cancer killed about 21,000 people and COVID-19 killed about 11,400 people.

“Unfortunately, it’s still number one,” Khandelwal said.

“I think people are very worried because of the sudden onset of a heart attack without warning, especially due to its time-sensitive nature,” Khandelwal said.

Some people take aspirin on their own, so he said he needs to talk to his doctor about whether to continue.

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