2012.03.21 05:32
An E-Mail came from one of my classmate's son who is a doctor appearing in the NBC interviews.
A review of studies in the medical journal Lancet suggests the benefits of aspirin may outweigh the risks.
Aspirin users have a 36 percent lower risk for having their cancers spread
and those who take aspirin have a 38 percent lower chance of developing colorectal cancer.
NBC’s Dr. Nancy Snyderman reports.
http://www.msnbc.msn.com/id/3032619/vp/46801645#46801645
The following article backs up the NBC reports.
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2012.03.21 05:54
2012.03.21 13:50
As you said, this is a complicated question.
This is what an internist does every day in each patient.
The decision requires a sound clinical, judgement based on
careful review of each patient's case and family history.
The advances in human genetics will soon give us a helping hand in further clarifying
each individual case, I hope.
One of the original studies with aspirin 325 mg every other day on
doctors in USA some 30 years ago (double blind control with placebo)
which showed the benefit of cardiac protection did show increased incidence of
hemorrahgic stroke(something like 75 out of 30 some thousand I believe. I could be wrong
in precise numbers) in aspirin group although they said it was not statistically significant.
There is a recent data that indicates that the risk of colorectal cancer after age 70 in asymptomatic
patients is very low and a routine colonoscopy in elderly asymptomatic patents with no family history may not be
warranted or advised. This indicates the age of the patient is an important factor without a doubt.
As a physcian, one can only take the information presented here as one of many considerations
in deciding what to do in each patient with a whole host of clinical and genetic factors.
I've been in internal medicine and cardiovascular practice over 40 years.
Many of my patients have been on aspirin 10, 20, 30 and 40 years.
I have seen enough number of patients developing anemia from aspirin 81 mg a day after many years.
Their hemoglobin gradually goes down little by little. Initially I used to subject them to EGD and colonoscopy
not to miss cancer, polyps or ulcers. But I changed the strategy some time ago.
I stop the aspirin for a few weeks, then repeat the CBC. More often than not the count goes up.
I often put him on H2 blockers at the same time.
Cerebral hemorrhage is of course a bad news. And the combination of aspirin and hypertension is a good receipe
for it particulary when you add Plavix or Effient to it.
I also would like to refer to my presentation, "Aspirin for a primary prevention" on this page,
which makes us think twice in regard to the routine use of aspirin 81 mg a day for primary prevention
of CAD because of its bleeding risk.
I guess these two articles are nothing new.
But it confirms and enforces what we have known already for a while.
Conclusion: Benefit outweighs risk ??
본인도 baby aspirin one a day 의 장기 복용자였고, 약 12년간의 복용중 전혀 부작용이 없었지요.
단지 운동이나 집안일 하다가 피부를 다치는 경우에 지혈이 두배쯤 지연되는것을 번번히 목격한것뿐이였지요.
최근에 aspirin을 중단했지요.
이유인즉, 최근에 우리 은퇴촌 사람 두명이 급성 뇌출혈로 사망내지는 고생했기에 은근히 겁이 났기 때문입니다.
본인 모친께서 95세로 2002에 수원병원에서 CVA로 돌아 가셨을때, 소위 주치의라는 자를 만날수도 없었고
어떤 종류의 CVA 였었는지 알수도 없었지요. 아직도 한국 의사들은 이런 꼴이더군요.
만일 모친께서 Cerebral hemorrhage로 돌아 가셨다면, 본인의 aspirin 복용이 문제가 되지 안을가 걱정이 되더군요.
Unconfirmed family history 외에는 I have had no contraindication for aspirin.
I have a borderline hypertension well controlled by minimum medications
and occasionally engage in some strenuous sports.
이 글을 읽고, 다시 재복용을 고려중입니다.