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An aspirin a day? Maybe not, if you've got heart problems

Taunton Daily Gazette - 7/28/2019

Jul. 26--Millions of Americans take a daily dose of aspirin to lower the risk of heart attack and stroke, but a new study shows it may have only marginal benefits -- and dangerous health consequences.

Increased risk of bleeding could result, according to Dr. Colin O'Brien, lead author of the study conducted by researchers at Boston'sBeth Israel Deaconess Medical Center and which appeared in Monday's "Annals of Internal Medicine."

About 29 million Americans age 40 and above, without cardiovascular disease, take aspirin daily, according to the study. More than 6 million in that population are doing so without a doctor's recommendation.

As for older Americans, about 10 million over the age of 70, without heart disease, are taking a daily aspirin, despite national health guidelines that tell them not to do it.

Conventional wisdom was a daily aspirin could help ward off cardiovascular disease for those at higher risk.

However, the American Heart Association and American College of Cardiology changed its guidelines this year after three studies showed marginal benefits and an increased risk of internal bleeding.

Now, both organizations recommend no daily aspirin for those older than 70, and for people with increased bleeding. Both categories apply to those without existing heart disease.

Those who continue taking aspirin every day could experience a higher risk of internal bleeding, according to O'Brien.

The study also found more than 2 million Americans taking aspirin for peptic ulcers -- painful sores in the lining of the stomach that are prone to bleeding -- experienced a higher risk of gastrointestinal bleeding.

"Talk to your doctor," O'Brien said to encourage patients to speak with their primary care physicians to see if taking aspirin is the way to go. Physicians are also encouraged to speak with their patients, the study said.

Data from the 2017 National Health Interview Survey, an in-person survey of health and disability among U.S. adults, was the basis for the study.

O'Brien anticipates a possible follow-up study in the next couple years to determine if fewer patients are taking aspirin.

Meanwhile, he said he has patients that still take aspirin daily, and he's observed other primary care physicians in the same boat.

He's hoping updated guidelines and the Beth Israel study will encourage patients, and their doctors, to have frank discussions.

"Discuss the risks and benefits," O'Brien said. "Then a decision can be made based on what is right for the patient."

Henry Schwan is the health reporter for the MetroWest Daily News. Follow Henry on Twitter @henrymetrowest. He can be reached at hschwan@wickedlocal.com or 508-626-3964.

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(c)2019 Taunton Daily Gazette, Mass.

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