By Dr. Oz

The real story on taking daily aspirin

Sep 24, 2018 | 9:37 AM

At first we were a little concerned about our aspirin recommendations, after a study on aspirin and heart disease prevention was published online in The Lancet. News headlines declared the findings showed that taking a daily low-dose aspirin wasn’t much help in protecting you from heart disease.

One example: “Study: Daily Aspirin Won’t Prevent First Heart Attack.” But after reading the actual study — not the news reports — we discovered that the headlines should have declared: “Study Finds Aspirin Won’t Prevent First Heart Attack Unless Taken as Directed.”

So, here’s how we think you should talk to your doc about taking or continuing to take low-dose aspirin in order to prevent a first heart attack or stroke — and other health woes.

Just to be clear, there is a preponderance of data that shows people — especially guys over 40 who don’t do extreme sports and women over 50 — who take a low-dose aspirin or more a day (we say there’s a benefit to doing so morning and night) have a 10 to 40 percent decrease in the risk of nine cancers, including cancer of the breast, colon, esophagus, rectum and more, and a 10 to 35 percent reduction in recurrent heart attacks or strokes.

The study in question: The ARRIVE (Aspirin to Reduce Risk of Initial Vascular Events) study that’s being touted as an aspirin-debunker only required folks in the aspirin-taking group (more than 6,200 people from Germany, Italy, Ireland, Poland, Spain, the U.K. and the U.S.) to do so 60 percent of the time — and many of them failed to do even that! The researchers admit, some folks in the control group who were supposed to NOT take aspirin did so.

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Overall, of around 12,550 folks who were randomly assigned to either the aspirin-takers or no-aspirin-takers group, only 7,800 actually did what they were supposed to do! (Men were 55 and older and had two risk factors for coronary heart disease, such as elevated LDL cholesterol or hypertension; women were 60 and older and had three risk factors.)

But that’s not the whole story.

Among folks in the ARRIVE study who stuck with the prescribed dose of 100 mg aspirin daily, there was a 47 percent reduction in initial or first heart attacks!

The aspirin had significant benefits.

Clearly, being a tad compulsive about taking your meds, in this case aspirin, is a very, very good thing.

Yet more proof: ARRIVE’s findings came out on the same day the ASCEND study confirmed that taking daily aspirin prevents primary vascular events (that’s a first heart attack or stroke) in folks with diabetes, although it also increased bleeding risks. For the 30.3 million
Americans living with diabetes — and we say the other 69.7 million with prediabetes — it may be possible to modify the risk of heart disease (the No. 1 killer of folks with diabetes) if they take 100 mg of aspirin every day.

So what’s the real story? We continue to recommend (if your doc says it is OK) taking an 81-mg aspirin twice a day with half a glass of warm water before and after, as long as you do not do extreme sports or some other activity, such as taking recreational drugs and some prescription meds or have medical conditions, such as uncontrolled liver or kidney disease, that decrease the benefits of the aspirin or increase its risks.

Beware stop and start!

It’s risky to start taking aspirin regularly and then forget more than one dose (what the ARRIVE participants apparently did). If you do that, you’ll trigger a rebound increase in clotting. (A rebound also happens in cholesterol levels if you miss more than two doses of a statin and in blood pressure if you skip your antihypertensive meds.) And that rebound increases your risk of heart attack and stroke.

So if you’re a guy 40+ or a woman 50+ without added risks, and your doc agrees, start and stick with a daily aspirin regimen.
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Mehmet Oz, M.D. is host of “The Dr. Oz Show,” and Mike Roizen, M.D. is Chief Wellness Officer and Chair of Wellness Institute at Cleveland Clinic. To live your healthiest, tune into “The Dr. Oz Show” or visit www.sharecare.com.
© 2018 Michael Roizen, M.D. and Mehmet Oz, M.D.
Distributed by King Features Syndicate, Inc

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