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Got an ache or pain? Have a question about a prescription or over-the-counter drug? Looking for some FREE medical advice?
Question:
I am concerned about heart disease as my father has it and both grandfathers died of it. How effective is aspirin in preventing it, and at what age should I start taking it? How much should I take?
XXL
Answer:
Thanks for asking this question - it's a tricky one but one that deserves wider consideration, not least because there is so much (mis)information around. The short answer is - I would not recommend it purely on the basis of your family history. The absolute benefits in primary prevention of a heart attack (primary = stopping or at least delaying a first heart attack rather than secondary = reducing the risk of a more heart attacks after a first)are uncertain because they may be counterbalanced or outweighed by a (small) increase in the risk of stroke (bleeding in the brain) or other serious bleeding disorders - for example, from a "silent" stomach ulcer. The study that was most convincing to me was one done on over twenty thousand doctors: half took 325 mg of aspirin every second other day, half took a placebo. The total deaths in the aspirin group over the 5-year period of the study were 4% fewer than in the placebo group: this is NOT a statistically significant difference. A big reduction in fatal heart attacks of 69% which is significant however was matched by a nearly equal increase in sudden deaths from stroke and other disorder. The decrease in incidence of heart attacks was seen only the under-50s. If you're not keen on swapping heart attacks for strokes - a pretty awful choice either way you look at it - there's little benefit from aspirin. A number of other studies have confirmed this approach - and while it's equally fair to say that you can find yet other studies that have found benefit, there is no consensus among cardiologists that this is a good way of avoiding a heart attack. Best to stop smoking (or never start), get 40 minutes a day of reach-your-target-pulse exercise, and lower your cholesterol if it's up. Those three interventions will do far more to reduce your risk of heart attack even if your family history is not that good. I'd be interested in comments from other readers on this. Hope this helps
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