Stopping aspirin therapy may raise heart attack, stroke risk

Aspirin - cheap and perhaps lifesaving. So read how stopping aspirin therapy may raise heart attack, stroke risk:

Stopping low-dose aspirin therapy without good reason raises the likelihood of heart attack or stroke by nearly 40 percent, a large Swedish study suggests.

Doctors commonly prescribe daily low-dose aspirin after a heart attack to reduce the risk of having a second cardiovascular event. But about one in six patients stop taking their aspirin within three years, the study authors note in Circulation.

Wrong medicine for your particular stroke risks?

A few posts ago, I mention an article about the value of aspirin for those who experienced a mini-stroke.

Now, here's another article about when perhaps NOT to use aspirin when patients at risk for stroke get wrong medicine:

Researchers analyzed data on more than 500,000 people with atrial fibrillation, an irregular rapid heartbeat that can lead to stroke, heart failure and chronic fatigue.

Roughly 40 percent of these patients got aspirin instead of prescriptions for blood thinners – also called anticoagulants.

“By prescribing aspirin, we may be fooling ourselves

Aspirin and you - reasons to take that lowly pill

Take two aspirin and call me in the morning, the old joke goes.

Now, we're told, aspirin just after a mini-stroke (also known as a transient ischemic attack, or TIA). It might keep you out of trouble. Read about how an immediate aspirin after mini-stroke cuts risk of major stroke:

"A great many people who have (mini-strokes or TIAs) don’t seek medical attention, and don’t feel that it’s an emergency," said lead author Peter Rothwell of the Stroke Prevention Research Unit in the Nuffield Department of Clinical Neuroscience at John Radcliffe Hospital in Oxford in the U.K.

And the answer to the aspirin question is ...

Photo from Open Knowledge via Flickr

Those who are trying to prevent a stroke might feel like a ping pong ball.

There's been a bit of back and forth about who should take an aspirin every day to prevent strokes or heart attacks. Now, it seems we're now told that adults in their 50s should take aspirin daily:

Updated guidelines issued by the US Preventive Services Task Force recommend daily low-dose aspirin for the prevention of heart attack and stroke among adults aged 50-59 who are at high risk for cardiovascular disease. ...

Aspirin today? You are not alone - and maybe Missouri could do better

(Credit below)

You know, aspirin is good for headaches, too.

I ran across some numbers the other day about aspirin use - high numbers of users who want to avoid stroke or heart disease.

Within the heart patients surveyed, a fairly tiny number take aspirin for pain relief. It is actually a pretty good non-steroid anti-inflammatory, too, if you can stomach it.

One down note for my current state of residence - Missouri. Read about this and from a story running down the numbers on aspirin's common use:

Aspirin a day? Before you start (or stop) read further ...

Do you take an aspirin a day?

I used to, sometimes in combination with Plavix or warfarin as physician-directed. Aspirin sellers, of course, pitch this idea in advertising. I stopped taking it after a heart procedure that reduced my stroke risk and, with no other risk factors aside from age, my cardiologist told me it's not necessary.

Turns out that lots of people take a daily aspirin to prevent a stroke or heart attack. One recent story says a daily aspirin is taken by more than half of older U.S. adults:

Most appear to start taking daily aspirin after discussing the matter with a health care provider, said study lead author Craig Williams, a pharmacotherapy specialist at Oregon State University in Portland.

Right combo of aspirin and blood thinners found safe

I stopped taking blood-thinners seven years ago, after a heart procedure removed my extra-high stroke risk.

However, I always took them when ordered, despite the trouble of tests, diet-watching and bruising/bleeding risk.

Turns out, that's what you're supposed to do. Experts reported earlier this month that long-term use of aspirin plus blood thinner is safe:

The blood-thinning combination won't increase a patient's risk of early death, according to a new study presented Sunday at the annual meeting of the American Heart Association in Chicago. The report was also published online Nov. 16 in The Lancet.

Drug combo may reduce risk of second stroke

I was on aspirin and Plavix for several years to prevent a second stroke. I eventually had a mini-stroke (or a transient ischemic attack) anyway. Still, more info to discuss with your own doctor. Check out this article about how a study shows this drug combo may reduce risk of second stroke:

After suffering a stroke or a mini-stroke, patients are usually given aspirin to prevent clots that can cause another stroke. Now a new study suggests that adding the drug Plavix (clopidogrel) to the mix can reduce the risk of a second stroke by nearly a third over aspirin alone. ...

"Giving two drugs that block platelets works a lot better than aspirin alone in people who have had a minor stroke or TIA," said researcher Dr. S. Claiborne Johnston, a professor of neurology at the University of California, San Francisco.

The trial was done in China, so whether the results would be the same in the United States isn't known. "They probably are, but we would like to see them confirmed," Johnston said.

Remember: Take that medicine!

Are stroke survivors taking their medicine?

People who have had an ischemic stroke are at higher lifetime risk for another stroke, but several types of medication can reduce that risk. One of the simplest regimens involves antithrombotic medications, otherwise known as blood thinners, of which the most common is aspirin.

But a new UCLA study to determine whether the use of antithrombotic medications among stroke survivors increased over a seven-year period found that in each of the years, approximately 20 percent of survivors were not taking these medications — a figure that did not decrease during the time period. The study also found that individuals who were younger, female or Hispanic were less likely to be taking antithrombotic agents.

The findings appear in the January 2010 issue of the American Journal of Preventive Medicine.

(Image from National Library of Medicine)

Avoiding a second stroke - efforts needed

A recent article in U.S. News and World Report:

After suffering a stroke, the chances of having another are high, but a new report shows many patients aren't getting the interventions they need to reduce that risk.

Those interventions include lifestyle changes, such as smoking cessation and exercise, and medical treatments, such as aspirin, blood pressure medications and cholesterol-lowering drugs.

We need more and better strategies for these patients - rehab, counseling, medication, among other things. This Stroke Awareness Month is a good time to start.

All about stroke resources

An often-updated Web resource for stroke survivors, caregivers, loved ones and families: All About Stroke.

One good, educational article is about blood thinner medication - which clot-type stroke survivors often take - and the side effects. It covers aspirin, Aggrenox, warfarin, Plavix, heparin and enoxaparin, a particular form of heparin.

With the exception of enoxaparin (as far as I know), I've used them all and glad they're available to help with stroke prevention. The article does a good job of going quickly through the primary side effects to watch out for. Click on the drug names (or the photo of the pills) for additional links.

You can also sign up for an e-mail newsletter about stroke-related news from the site.

(Image from National Library of Medicine)

Aspirin can help

For Stroke Awareness Month, you might want to consider this easy and cheap preventive measure: taking a baby aspirin.

The St. Louis Post-Dispatch quoted Dr. Abdul Nassief, an assistant professor at Washington University and director of the clinical stroke center at Barnes-Jewish Hospital, that an 81-mg aspirin, every other day, reduces stroke risk. He cautioned against taking it, though, if your blood pressure is more than 140/90.

"It's a winner," Nassief told the newspaper. "And for women over 40, a baby aspirin every other day reduces the risk of stroke by 25 percent." And it doesn't matter if it's coated or uncoated, although the coated aspirin might cause less upset.

Not being a doctor myself, I'd always check with my doctor to see if there's any other reason not to take the aspirin, especially if you're already taking a prescription medication.