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Medical Forum / General / General / August 2004aspirin as a preventative --- basic query
I am 58 yrs. old in reasonable good health. I do have high cholestrol (usually about 230-235), but my doctor has not put me on medication as my other risk factors are low (no family heart problems, generally excellent bp of about 105/75 and pulse about 65-75 and I am not overweight and I am trying to do some more exercise such as about 75 minutes on treadmill about 3 days/week). My question concerns aspirin. My doctor is starting to suggest that his patients (in my type situation) take a baby aspirin per day (81 mg). Is this generally now recommended and also does it matter what brand or even what type (eg: chewable). Mel I'm a retired physician with decent chemistry and a strong family history risk of MI. My physician has placed me on this regimen. I think this is recommended in a very high percentage of senior patients. In fact, I don't understand why everyone isn't on 81mg/day of ASA. Good Luck in your quest. Kent > I am 58 yrs. old in reasonable good health. I do have high cholestrol > (usually about 230-235), but my doctor has not put me on medication as my [quoted text clipped - 9 lines] > > Mel > I am 58 yrs. old in reasonable good health. I do have high cholestrol > (usually about 230-235), but my doctor has not put me on medication as my [quoted text clipped - 7 lines] > generally now recommended and also does it matter what brand or even what > type (eg: chewable). The enteric coated aspirin might be better, because it will decrease stomach irriatation. Otherwise, the type or brand does not matter all. Jeff > Mel > My doctor is starting to suggest that his > patients (in my type situation) take a baby aspirin per day (81 mg). Is this > generally now recommended Yes, assuming that the risk/benefit ratio favors aspirin therapy (I'm assuming your doctor has gone through that exercise). I can't tell you, since you only provided a total cholesterol, and didn't mention your HDL, LDL, triglycerides, fasting blood sugar, waist circumference, smoking status, and whether or not your normal blood pressure is achieved with antihypertensive medications. Your HDL and LDL values in particular may in and of themselves determine whether or not daily aspirin therapy is a good idea at this point. As an example, using the total cholesterol values you gave, assuming your HDL is low-ish (35-39) and LDL is high (130-159), your 10-year coronary heart disease risk (based on ATP-III and the Framingham Risk Score (FRS) would be about 12%, making you a candidate for low-dose daily aspirin therapy (anything above about 10% tilts the risk-benefit ratio in favor of therapy). However, if your HDL is higher or your LDL lower, you may have a much lower 10-year risk, making aspirin therapy unnecessary (read: unhelpful and unnecesarily risky). > and also does it matter what brand or even what > type (eg: chewable). No, as long as the dose does not exceed 81mg daily. There is no additional benefit with higher doses, and the risk of bruising/bleeding will be greater. Griffin: My bp is natural--- no medications. I am a non-smoker. I don't have the figures in front of me, but the LDL/HDL figures are not really good as I recall. In fact, we discussed whether or not I should be on cholest. lowering medications. In my docs opinion, given all the info, we decided not to, but it is definitely an option. Mel > > My doctor is starting to suggest that his > > patients (in my type situation) take a baby aspirin per day (81 mg). Is this [quoted text clipped - 23 lines] > additional benefit with higher doses, and the risk of bruising/bleeding > will be greater. > I don't have the figures in front of me, but the LDL/HDL figures are not > really good as I recall. Then aspirin therapy is probably a good idea. > In fact, we discussed whether or not I should be on cholest. lowering > medications. In my docs opinion, given all the info, we decided not to, but > it is definitely an option. Without knowing the actual numbers, I can't make any recommendations. However, your own doctor knows you best. If your cholesterol is high, you definitely need to have a plan for bringing it down. Hopefully at this stage, since you've decided not to take medicine, you will be trying to eat a balanced, healthy diet (low in saturated fats, high in fiber, and including plenty of cold-water fish which are rich in omega fatty acids), increase your level of cardiovascular exercise (a minimum of 30 minutes three times per week), and (if appropriate) lose some weight. These will all have beneficial effects on lowering LDL and raising HDL. Your doctor should recheck your cholesterol in 3-6 months, and if diet and lifestyle modifications are not working, medication (particularly a statin) should be given serious consideration, with the goal of achieving and maintaining your lipid goals. Good luck. |
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