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DEAR DR. ROACH: A column in a popular consumer magazine states that taking a baby aspirin daily does more harm than good, and it should not be taken unless you have heart disease. I have been taking a baby aspirin daily for 10 years, and now I’m concerned. Your thoughts, please. – G.D.
ANSWER: Experts disagree on the best advice. Some points, however, are not controversial: Aspirin is beneficial for reducing future heart risks in people with established heart disease, but it increases the risk of bleeding events. Some of these are minor, but a few are potentially life-threatening.
According to a recent review of published studies, in people at higher-than-average risk for heart disease, a daily aspirin reduces the risk of a nonfatal heart attack by about 20 percent, without significantly changing stroke risk or risk of dying from heart disease. Risk of bleeding is increased by 50 percent. Also, newer evidence suggests that aspirin may decrease the risk of some cancers, especially colon cancer.
Aspirin is more likely to have a net benefit in people with higher risk of heart disease, even if it isn’t diagnosed. The decision of taking aspirin should be made after a thorough review of all your individual risk factors, including heart disease risk and history of bleeding, and possibly colon cancer risk. When I discuss aspirin with patients, I very seldom recommend it to anyone with no known coronary disease who has had a significant side effect (such as bleeding) with aspirin in the past. As more studies are failing to show benefit, these recommendations may change.
DEAR DR. ROACH: I am a 48-year-old woman in pretty good health. I was a smoker for 30-plus years and quit about three years ago. I don’t have any signs of COPD or other lung ailments yet, but I fear they are just around the corner. My question is, is there anything I can do now to postpone or prevent the onset of these diseases, or at least decrease their severity? – V.M.
ANSWER: Not all smokers will develop COPD. Some smokers are more susceptible than others to the effects of the many toxic chemicals in tobacco smoke. Conversely, some nonsmokers can develop COPD, especially those who lack a protective enzyme, alpha-1 antitrypsin; this is more likely in those exposed to secondhand smoke or other airborne pollutants.
Quitting smoking is by far the most important action you can take to reduce your risk of developing lung disease, but there may be others. Avoid other airborne pollutants, especially other smokers, but also dusts and fumes.
Some preliminary evidence suggests that statin drugs might slow down COPD, but there are conflicting studies, and I don’t recommend them just for COPD. Regular exercise may help, and it certainly helps your heart and many other systems.
The booklet on COPD explains in detail both emphysema and chronic bronchitis, the two elements of COPD. Readers can obtain a copy by writing: Dr. Roach – No. 601W, 628 Virginia Drive, Orlando, FL 32803. Enclose a check or money order (no cash) for $4.75 U.S./$6 Canada with the recipient’s printed name and address. Please allow 4-6 weeks for delivery.
Dr. Roach regrets he is unable to answer individual letters, but will incorporate them in the column whenever possible. Readers may email questions to ToYourGoodHealth@med.cornell.edu. To view and order health pamphlets, visit www.rbmamall.com.
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