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

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

epicresearch.org

41 pointssalkahfi13 comments

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

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.

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

I haven't heard about it, but the combo would have a synergistic effect as they both address different coagulation pathways. I take them together for other reasons - I take vitamin K (K1, and K2 in MK-4 and K2 MK-7 forms) to direct calcium to the bones, not to the tissues, and, of course, anticollagulation. For the latter, I also take Nattokinase, but the main reason I take Aspirin is its protection against cancer.

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-...

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?

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.

>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?

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.

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.

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

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

Regarding bleeding risks.

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

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