Thursday, April 16, 2009

Aspirin On The Brain

When did an aspirin-a-day replace the apple for keeping the doctor away?

Millions of Americans are on a daily aspirin regime in the hopes of preventing a cardiovascular event.
The ones I see tell me, "It's just a little baby aspirin".
Kudos to the marketers for that. Turning a drug responsible for significant morbidity and mortality into harmless just a little baby aspirin was genius.

2003: The FDA Cardiovascular Advisory Committee rejects approval of aspirin for use to reduce the risk of a first heart attack.
Apparently, the risk of haemorrhagic stroke and gastrointestinal bleeding were trade-offs the committee found weighing heavily against an approval.

Bloody Brains

That haemorrhagic stroke bit comes to mind today as I read findings published in an online report of the Archives of Neurology on April 13th.
seen here:

Finding: Aspirin increases risk of bleeding in the brain 70%. Low doses (BABY ASPIRIN) taken daily were more likely than larger doses taken infrequently to cause bleeds.

good review of the research on a simplistic level:

I fear the steam behind the aspirin-a-day train will lead to this research being run over flat.
Already I see the seemingly dispassionate and reasoned swipes at the findings.
If you read enough commentary on the topic, you too will begin to see a pattern of down-playing the study. And all quite reasonable.

My concern is this, from the nhs link above: "Anti-clotting drugs are known to increase the risk of bleeding and when prescribing them, clinicians should carefully consider both the risks and benefits of treatment on an individual basis."

Clinicians should carefully consider?
Aspirin is OTC.
People are self-medicating.
They have been sold on aspirin-a-day.
Clinicians have been prescribing the regime for years.
What risk?
It's just a little baby aspirin.

From THE aspirinwonderdrug people, an interesting history of the drug
An aspirin alternative page from 1970, only really interesting for the Q and A on priapism