Heart Podcast Aspirin: latest evidence and developments
Nov 19, 2024
In this engaging discussion, Mark R Nelson, a general practitioner and researcher at the Menzies Institute for Medical Research, dives into the multifaceted world of aspirin. He explores its historical significance and current guidelines, shedding light on its evolving role in cardiovascular and cancer treatment. Recent large-scale trials are scrutinized, revealing aspirin's potential benefits and risks—especially for the elderly. With fascinating insights into its possible applications beyond heart health, this conversation offers a fresh perspective on aspirin's future in medicine.
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Aspirin's Bleeding Risk Discovery
- A Californian GP in the 1940s noticed increased post-operative bleeding in pediatric tonsillectomy patients given aspirin-laced chewing gum.
- This led to the idea of "an aspirin a day to prevent MI", although based on weak observational data.
Evolving Aspirin Guidelines for Primary Prevention
- Aspirin's primary prevention recommendations have narrowed due to a less favorable risk-benefit profile in recent, larger trials.
- Older adults, especially over 60, are now generally advised against initiating aspirin for primary prevention.
Aspirin in Secondary Prevention
- Aspirin is still recommended for secondary prevention of cardiovascular disease at 75-100mg daily.
- The main advantage of aspirin compared to newer antiplatelet agents remains its low cost.