Low-Dose Aspirin Usage for Primary Prevention Has Fallen by >50% Since 2018

Low-Dose Aspirin Usage for Primary Prevention Has Fallen by >50% Since 2018(epicresearch.org)

41 points by salkahfi 21 days ago | 13 comments

Great to see an example of concrete evidence that physicians made changes when the evidence showed a change was needed.

nikolay 21 days ago | |

This "evidence" is highly questionable. There's other evidence, i.e., that taking aspirin with DGL or vitamin C does not damage the stomach lining, have led to new formulations decades ago. In fact, high doses of aspirin have been sold in Europe combined with vitamin C for as long as I remember - Aspirin C by Bayer and Upsarin C by UPSA. There's other evidence, too, that aspirin protects against cancer.

teslabox 21 days ago | | |

My understanding is the bleeding risk associated with aspirin can be addressed by taking Vitamin K.

Herodotus38 21 days ago | | |

Sounds like you have additional and better evidence than the USPTF that made the changes in aspirin for primary prevention. They do have a method to give feedback, and based on my experience a person will respond to you personally. I suggest you submit your information to them.

https://www.uspreventiveservicestaskforce.org/uspstf/public-...

robocat 20 days ago |

US study. From link:

  Patients with conditions that would indicate aspirin use for secondary prevention (such as coronary artery disease, prior stroke, or peripheral artery disease) as well as those for whom aspirin was contraindicated due to allergy or pregnancy were excluded.

So they excluded "coronary artery disease, prior stroke, or peripheral artery disease" which covers most people that might be prescribed aspirin? Who's left?

OutOfHere 21 days ago |

Low-dode aspirin wrecks the stomach or small intestine anyway in many individuals, irrespective of its form. This strikes a lot sooner than internal bleeding. Both the chewable and the enteric-coated forms cause this injury at separate locations.

cucumber3732842 21 days ago | |

>in many individuals,

So then why are we not working to determine which individuals it is suitable for?

What is the alternative to aspirin for this use case and who benefits?

OutOfHere 21 days ago | | |

One just finds out by trial and error, although the injury can take many months to manifest, and is slowly reversible upon cessation. As for the safer pharmaceutical alternative, clopidogrel is it, again in a sufficiently low dose, but it is not OTC.

clumsysmurf 21 days ago | |

Its probably best to talk to your doctor about a CAC score. I don't know if its possible to tell stable vs unstable plaque yet, but a higher CAC score may benefit from aspirin.

nikolay 21 days ago | |

It doesn't, as it doesn't dissolve in the stomach, thanks to its enteric coating.

red-iron-pine 21 days ago |

guessing ozympic, statins, and stomach staples + pretty reliable stats about causing internal bleeding

vlod 21 days ago |

Regarding bleeding risks.

Is this due to the stomach being empty? Does taking it at the end of a large meal better?

Patients with conditions that would indicate aspirin use for secondary prevention (such as coronary artery disease, prior stroke, or peripheral artery disease) as well as those for whom aspirin was contraindicated due to allergy or pregnancy were excluded.