After years of doctors recommending low-dose aspirin as a preventative measure against cardiovascular disease and colon cancer, the last few weeks of 2018 brought a wave of confusing news from the research world.
Is an aspirin regimen good or bad for you? Sometimes it’s hard to tell.
“Even clinicians get confused,” said Dr. Xavier Prida, a cardiologist at the University of South Florida. “One study could show a positive outcome one week, then a completely different study can show a negative outcome the next.”
One study published in the New England Journal of Medicine followed 19,000 people age 70 and over for nearly five years and found that low-dose aspirin did not significantly reduce the risk of cardiovascular disease in that group. It also found a “significantly higher risk of major hemorrhage” in those patients.
That was in October.
Then earlier this month, researchers at Moffitt Cancer Center in Tampa found that women who take low-dose aspirin have a better chance of preventing ovarian cancer and improving their survival of the disease.
Around the same time, another study from researchers at the University of Florida concluded that healthy adults who take aspirin may be doing more harm than good, and are at greater risk of internal bleeding and other health issues.
“This is hard for patients, but also the physicians,” Prida said. “Patients are looking to their doctors for advice and guidance but it can difficult for one doctor make a choice based on new research that’s best for their patient.”
The only way to find the answer, medical professionals say, is to read between the lines.
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“We don’t always do a good job explaining how this may apply to people,” said Shelley Tworoger, associate center director of population science at Moffitt. She was the senior author on four published studies looking at the link between women, medication and ovarian cancer.
“The population of people being studied is what matters most,” Tworoger said. “Patients should be asking themselves how similar is that population to their situation.”
For example, the Moffitt studies focused on large populations of women from around the globe that asked women about the medication they took at one point in time, and followed them to identify those who developed cancer. In all, their study included more than 750,000 women. Of that group, over 3,500 were diagnosed with ovarian center.
Regarding aspirin, Tworoger said, “there does seem to be a ‘sweet spot’ for benefits of use, which can be outweighed by the potential harm in some groups of people.”
She added: “There’s a reason why the U.S. Preventive Services Task Force explicitly doesn’t recommend aspirin use for specific age groups. In younger age groups, there’s a higher risk of harm. So as researchers, we must try to target populations who could see benefits.”
In a study published this month in the European Heart Journal, researchers at the University of Florida determined that healthy people who take low-dose aspirin are about 50 percent more likely to experience major bleeding, compared to those who did not use aspirin. The study looked at data from 11 aspirin therapy clinical trials, which involved more than 157,000 healthy people since the 1980s.
The results showed that aspirin does not reduce deaths, heart attacks or strokes, said one of the researchers, Dr. Anthony Bavry, an associate professor in the UF College of Medicine and a cardiologist at the Malcom Randall VA Medical Center in Gainesville.
“I can’t tell people they should be taking aspirin or not. That needs to be a discussion between a person and their physician,” Bavry said. “It’s very dynamic, to come to a conclusion. Health care is changing right now, and there’s a reappraisal happening for the risk and benefit of many drugs and devices, including aspirin.”
Patients should arm themselves with as much information as possible, Bavry said, but always consult their doctor before altering their medication routines.
“If you’ve had a heart attack or stroke, aspirin is beneficial in that scenario. But if you’re looking for prevention and don’t have a history of heart problems, then aspirin could be harmful,” he explained.
It oftentimes takes years, after one medical study is published, before agencies will recommend a new drug or therapy as safe for consumers. Usually more studies are performed, and it can be hard for different researchers to come to the same results, said Prida, the USF cardiologist.
So patients should be wary about jumping too quickly onto new medical trends, he said.
“There’s a long lag before it becomes established therapy,” Prida said. “So I tell my patients I do not reflectively respond to just one study. I wait for the aggregate data to be accrued.”
Contact Justine Griffin at [email protected] or (727) 893-8467. Follow @SunBizGriffin.
Understanding medical research
Research on new medical trends can be encouraging but also confusing for patients wanting to apply the latest breakthroughs to their health situation. Here’s where you can find guidance on how to interpret the information:
• The U.S. Preventive Services Task Force is an independent, volunteer panel of national experts in disease prevention and evidence-based medicine. The task force makes evidence-based recommendations about clinical preventive services.
• The Food and Drug Administration and Centers For Disease Control and Prevention approve new drugs and therapies, but also outline recommendations for patients.
• Several accredited medical associations make recommendations based on research and have resources available for patients. They include the Association of American Physicians, the American Academy of Pediatrics and the American College of Obstetricians and Gynecologists.
• Above all, patients should consult their doctor with questions and concerns.