The Danger of Daily Aspirin | Hacker News Reader

The Danger of Daily Aspirin

online.wsj.com

14 pointscwan18 comments

It's an optimization problem:

The positive side is the decreased risk of heart problems.

The negative side is the increased risk of stomach problems.

If you are at a low risk for heart problems, the negatives generally out-weigh the positives. If you are at a high risk for heart problems, the positives might out-weigh the negatives, since heart problems are more likely to be fatal than stomach problems.

According to TFA, recommendations for daily aspirin are too common.

I take ibuprofen every day, because I get a headache every day. 2 GP's and a psychiatrist have told me this is no big deal, but stories like this always bother me.

This is a shot in the dark, but is your jaw sore or tired in the morning? I clench my teeth when I sleep. When I'm stressed, I clench even more, causing bad headaches. It took me years to realize that the clenching was causing the headaches.

My dentist fit me for one of these: http://www.nti-tss.com/index.php?option=com_content&task...

Note this is different from a mouthguard; mouthguards allow you to clench, they just cushion a bit and protect your teeth from damage. This device keeps your teeth separated by a few centimeters. When your teeth are separated, you can't clench your jaw tight - which means the muscles controlling your jaw won't be fully engaged all night, alleviating the headaches.

At least, that's what caused my headaches. Again, it's a shot in the dark that it's what causes yours.

Most of the side-effects the article warns about are because of aspirin's blood-thinning effects and the possibility of causing gastrointestinal bleeding. Ibuprofen isn't a blood thinner, and the chances that it'll cause GI bleeding are much less than with aspirin. The doctors you talked to definitely knew this stuff.

If you're taking a painkiller every day, the headaches at this point may be 'rebound headaches'.

Have you tried stopping for a while?

I've tried just persisting through them but never lasted more than 2 weeks. Though every few months, they'll stop for maybe a week, and then come back. Caffeine makes them less bad, which is annoying because I don't like the energy swings, but every time I give up caffeine the headaches get worse (not just immediately after, but even a month after)

That's a really bad problem to have :( Do you know what's causing them?

I have Samter's triad and would benefit from daily aspirin use (325mg+), but the side-effects concern me and my default position is to avoid medication.

It would make more sense to me to just reduce the dose rather than cut it out completely. Maybe just take one every other day or 3-4 times a week.

By what rationale does that make more sense? The argument presented in the article is that for most people, the side-effects outweigh the protective benefits. How do you know that your suggestive diminishes the side effects to the point that even people who have a low risk for heart problems will have a net benefit?

For years I've taken two 325mg aspirin once or twice a week rather than take the small 81 mg each day. Works better for me.

... How do you know it works better?

For some reason it doesn't bother my stomach as does the daily 81 mg dose. Also, I usually get a headache at least once or twice a week and taking two aspirin always helps.

Breaking News: Even drugs you're familiar with have side-effects. More at eleven.

There's a comment like this for every article. Maybe someday al-Qaeda terrorists will genetically engineer a plague virus that turns everybody into "28 Days Later"-style zombies. Somebody will be here saying, "breaking news - Islamists don't like us."

This is actually a little more significant than finding some side effects. It means that the daily aspirin they've been telling us to take for decades may actually be worse than useless.

Which "they" are you referring to who has been telling you for decades to take aspirin? The drug companies, the media, or your own doctor?

The only one of those three that I would actually listen to, my personal physician, has never once suggested that I take aspirin daily, surely because I'm not a high risk for heart disease or stroke.

I'm curious if it really is common for physicians to blindly prescribe aspirin. The article itself doesn't specifically identify any case where a patient was prescribed daily aspirin. It sounds like the people mentioned decided on their own to start taking it.

I actually looked this up earlier, and here's the summary: In 2002, guidelines from some government agency said that people whose risk of heart disease outweighed their risk of bleeds should take it. Essentially this meant most men over 40. At the time, there was no evidence that daily aspirin decreased total mortality. In 2009, they revised it to exclude a lot more people because of the risk of bleeds. Now maybe they'll exclude even more people. I'm not going to dig the sources up again, but that's what I found.

I don't know how long they've been telling people to take it, but I know my dad was taking it in the 80s. His risk factors were being a man in his 40s and mild hypertension.

This fits in with a pattern in which doctors jump to conclusions and tell everybody to do something which turns out to be useless or harmful based on scanty evidence.

Reply on news.ycombinator.com