Aspirin has a very long and celebrated history of relieving headaches, but just now it’s threatening to create a pretty big one for pharmaphobic geezers like me.
Recent research is touting the health benefits of a daily dose of the little white pill as a preventive measure against heart disease and colorectal cancer despite FDA warnings that such a dosage — especially for those 60 and over — could cause a stroke or intestinal bleeding. It’s another case of picking your poison, though in this case there’s no cynical Big Pharma backstory to simplify the choices. It’s just aspirin, for goodness sakes. People have been using salicylic acid medicinally ever since the Sumerians starting chewing on willow tree bark 4,000 years ago. You don’t even need a prescription.
And for someone who (1) avoids pharmaceuticals at all costs and (2) whose parents battled unsuccessfully with heart disease and colon cancer, it’s the sort of thing that tends to raise uncomfortable questions.
Last week’s release of a University of Southern California study recommending the daily aspirin regimen was designed to clarify conflicting government positions on the aspirin issue. It essentially endorsed an earlier report from the U.S. Preventive Services Task Force (USPSTF) that challenged the FDA’s more cautious approach, though its conclusions seemed more designed for an actuarial mind than an actual one.
The USPTF recommendations for aspirin go something like this:
A low-dose aspirin regimen can help prevent heart disease and colorectal cancer “for only certain older adults: those 50 to 59 years old who have at least a 10 percent or greater chance of developing heart disease in 10 years, are not at increased risk for bleeding, have a life expectancy of at least 10 years, and are willing to take low-dose aspirin daily for at least 10 years.”
Oh, and then there’s this: “Adults 60 to 69 years old who face a greater than 10 percent risk of developing heart disease and a risk of bleeding may decide individually whether to take aspirin every day (italics are mine). Anyone else in that age bracket who is expected to live another 10 years is more likely to benefit.”
So, to review: If I have a 10 percent chance of developing heart disease in the next 10 years and some unknown risk of fatal bleeding and some unknown life expectancy, I may or may not benefit from taking aspirin every day for the next 10 years.
USC researchers sought to clarify the USPTF guidelines by calculating the benefits of following the recommendations, the results of which hardly inspire confidence. They figured that if 1,000 older adults each took an aspirin a day for 10 years, 11 of them would not develop heart disease and four would steer clear of cancer. Life expectancy for these aspirin-eaters would improve by a little more than three months.
Oh, and about two-thirds of those life-expectancy improvements would be accompanied by some sort of disability. And two out of every 63 aspirin aficionados should plan to suffer a “bleeding incident” between the age of 51 and 79.
I think I feel a headache coming on.