Heart attacks, aspirin and a small saga, reality check

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ODA 226
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Re: Heart attacks, aspirin and a small saga, reality check

Post by ODA 226 » Sat Apr 06, 2013 8:48 am

I take two asprins every morning as soon as I wake up as "preventative medicine".
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Re: Heart attacks, aspirin and a small saga, reality check

Post by ZombieGranny » Sat Apr 06, 2013 11:49 am

...
Last edited by ZombieGranny on Sat Sep 27, 2014 8:15 pm, edited 1 time in total.
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Re: Heart attacks, aspirin and a small saga, reality check

Post by Trident » Sun Apr 07, 2013 3:11 pm

Thank you for being your floor's safety guy and taking all the first aid preparedness trainings.

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Re: Heart attacks, aspirin and a small saga, reality check

Post by Krustofski » Sun Apr 07, 2013 3:29 pm

ODA 226 wrote:I take two asprins every morning as soon as I wake up as "preventative medicine".
Dude, regular Aspirin doses over 150 mg daily carry a certain cardiovascular risk in and on themself. That is to say, in the long run, they are not at all that good for your heart. Also, most definetely bad for your stomach.
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Re: Heart attacks, aspirin and a small saga, reality check

Post by ODA 226 » Mon Apr 08, 2013 5:40 am

Krustofski wrote:
ODA 226 wrote:I take two asprins every morning as soon as I wake up as "preventative medicine".
Dude, regular Aspirin doses over 150 mg daily carry a certain cardiovascular risk in and on themself. That is to say, in the long run, they are not at all that good for your heart. Also, most definetely bad for your stomach.
My college roommate who is now a Medical Doctor and Surgeon, recommended that I take that dose every morning as a stroke and heart attack preventative. (My family has a history of both.)
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Re: Heart attacks, aspirin and a small saga, reality check

Post by ZombieGranny » Mon Apr 08, 2013 11:07 am

...
Last edited by ZombieGranny on Sat Sep 27, 2014 8:15 pm, edited 1 time in total.
In my day, we didn't have virtual reality.
If a one-eyed razorback barbarian warrior was chasing you with an ax, you just had to hope you could outrun him.
-
Preps buy us time. Time to learn how and time to remember how. Time to figure out what is a want, what is a need.

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Re: Heart attacks, aspirin and a small saga, reality check

Post by Boondock » Mon Apr 08, 2013 12:55 pm

ODA 226 wrote:My college roommate who is now a Medical Doctor and Surgeon, recommended that I take that dose every morning as a stroke and heart attack preventative. (My family has a history of both.)
My doctor at the VA also recommended taking one baby aspirin, after eating, daily, for heart health and general pain management.

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Re: Heart attacks, aspirin and a small saga, reality check

Post by Krustofski » Mon Apr 08, 2013 4:02 pm

I talked to someone who is kinda a bit of an expert on the whole long-term Aspirin dosage thing, and he promised to do a short writeup for me, which I should have by tomorrow evening.
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Re: Heart attacks, aspirin and a small saga, reality check

Post by Vicarious_Lee » Mon Apr 08, 2013 4:26 pm

ODA 226 wrote:
Krustofski wrote:
ODA 226 wrote:I take two asprins every morning as soon as I wake up as "preventative medicine".
Dude, regular Aspirin doses over 150 mg daily carry a certain cardiovascular risk in and on themself. That is to say, in the long run, they are not at all that good for your heart. Also, most definetely bad for your stomach.
My college roommate who is now a Medical Doctor and Surgeon, recommended that I take that dose every morning as a stroke and heart attack preventative. (My family has a history of both.)
The short answer is that your surgeon friend is incorrect. The maximum blood-thinning effect of aspirin is achieved at 81mg. Any dose stronger than that just causes more pain relief, more stomach irritation, and at extreme levels more tinnitus (way above 650mg though).

Unless the information I was given on the subject is now obsolete. I'd like to see Krustofski's info.
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Re: Heart attacks, aspirin and a small saga, reality check

Post by Boondock » Mon Apr 08, 2013 4:33 pm

Of course, I won't blink when it's discovered that aspirin use causes heart failure. In the future, it'll be like in this movie gem:


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Re: Heart attacks, aspirin and a small saga, reality check

Post by Krustofski » Tue Apr 09, 2013 1:23 pm

Hi.

This is TheOldDopePeddler posting from Krustofski's computer. He thought this would be right up my alley. He also offered me a beer for this.

This is an amazing story, and from my point of view ninja-elbow did everything he was supposed to do.

Please note: I'm not dissing giving someone who is experiencing symptons of a heart attack a regular dose of aspirin. This is a great idea. A high dose, fast action, short term. Nothing wrong with that.
In the rest of this post, I'm going to talk about long-term treatment with aspirin to PREVENT cardiovascular events, which is an entirely different story.

ODA 226 wrote:
Krustofski wrote:
ODA 226 wrote:I take two asprins every morning as soon as I wake up as "preventative medicine".
Dude, regular aspirin doses over 150 mg daily carry a certain cardiovascular risk in and on themself. That is to say, in the long run, they are not at all that good for your heart. Also, most definetely bad for your stomach.
My college roommate who is now a Medical Doctor and Surgeon, recommended that I take that dose every morning as a stroke and heart attack preventative. (My family has a history of both.)
ZombieGranny wrote:That's a lot of aspirin.
Were you told to take so much?
Hubby takes an 81 mg aspirin daily - one regular aspirin tablet contains 325 mg, so if you take two you are taking 650.
In most European countries adult aspirin contains 500 mg per tablet, while the American standard is 325 mg per tablet, but that's not the point. Whether it's 1000 mg a day, or 650 mg a day, for prevention of cardiovascular dissease, both are too much.

Both "Baby Aspirin" and acetylsalicylic acid for prevention of atherothrombotic events contain 81 mg per tablet in the US. This strange number is simply a result of 325/4 = 81.25.
In Europe, the standard dose for this purpose is 100 mg (e.g. Aspirin Protect by Bayer), or 75 mg in some countries.

Both the European Society of Cardiology and the American College of Cardiology have formulated guidelines concerning optimal aspirin doses for the prevention of ACS. Both recomend low doses of aspirin. While they differ in details, their range is 75 to 150 mg per day.
The time when 600 or even 1000 mg of aspirin a day was thought to be a good idea is long gone. Those numbers were made up anyway, while modern guidelines are based on actual scientific data.

Taking more than 150 mg of aspirin per day for this purpose for any prolonged period of time is advised against. This is for two reasons:

- The whole stomach ulcer thing that exists with all NSADs. I'm not going to go into that. When it comes to the mucous membranes in your GI tract, all of them suck. Fullstop.
While the anti-inflamatory and pain-relief effects of ASA are NOT maxed out at 81 mg, the platelet inhibition effect is. You dose higher, all you'll get is stomach ulcers. Which you probably won't notice because you're taking a pain killer. Bad.

- Like any NSAID or COX-2 inhibitor, acetylsalicylic acid can interfere with the vasoprotective effects of prostaglandins. I.e. while aspirin may prevent the formation of blood clots due to its platelet inhibion, it can at the same time cause damage to blood vessels if the dose is too high. This reduces its cardioprotective properties if you take too much of it.

This has been known for quite some time, but just recently sprung to the attention of people in the pharmaceutical industry. A large Anglo-Swedish company had to jump through some hoops to get FDA approval for their new antiplatelet drug, while the EMA (EU FDA equivalent) approved it right away. The studies showed the new drug was less effective at preventing cardiovascular death in the US than it was in Europe. It turns out that this was because Americans tend to eat aspirin like candy.
Europeans are known for being paracetamol (acetomiophen) abusers, on the other hand. ;)

In short:

- It has been known for quite a few years that when it comes to aspirin and heart attacks, less is sometimes more.
- The ideal daily dose of aspirin in someone with a history of ACS is generally thought to be 75- 150 mg.
- One Baby Aspirin (or 81 mg) a day is right within this range. Two regular aspirins are not.
- Some doctors are working with outdated approaches, and old inconclusive data.


Then again, if an actual physician adivsed you to do something, listen to him. Don't follow random guys on the internet. That's generally a bad idea.

However, said physician might have some reading to do.


References, because everyone loves them (and Krustofski offered me another beer for proper sourcing):

Antithrombotic Trialists' Collaboration (2002) Collaborative meta-analysis of randomised trials of antiplatelet therapy for prevention of death, myocardial infarction, and stroke in high risk patients. BMJ 324(7329):71-86

Antithrombotic Trialists' Collaboration (2009) Aspirin in the primary and secondary prevention of vascular disease: collaborative meta-analysis of individual participant data from randomised trials. Lancet 373(9678):1849-60

Bhatt DL, Scheiman J, Abraham NS, Antman EM, Chan FK, Furberg CD, Johnson DA, Mahaffey KW, Quigley EM, Harrington RA, Bates ER, Bridges CR, Eisenberg MJ, Ferrari VA, Hlatky MA, Kaul S, Lindner JR, Moliterno DJ, Mukherjee D, Schofield RS, Rosenson RS, Stein JH, Weitz HH, Wesley DJ (2008) ACCF/ACG/AHA 2008 expert consensus document on reducing the gastrointestinal risks of antiplatelet therapy and NSAID use: a report of the American College of Cardiology Foundation Task Force on Clinical Expert Consensus Documents. J Am Coll Cardiol 52(18):1502-17

Campbell CL, Smyth S, Montalescot G, Steinhubl SR (2007) Aspirin dose for the prevention of cardiovascular disease: a systematic review. JAMA 297(18):2018-24

Graham I, Atar D, Borch-Johnsen K, Boysen G, Burell G, Cifkova R, Dallongeville J, De Backer G, Ebrahim S, Gjelsvik B, Herrmann-Lingen C, Hoes A, Humphries S, Knapton M, Perk J, Priori SG, Pyorala K, Reiner Z, Ruilope L, Sans-Menendez S, Scholte op Reimer W, Weissberg P, Wood D, Yarnell J, Zamorano JL, Walma E, Fitzgerald T, Cooney MT, Dudina A (2007) European guidelines on cardiovascular disease prevention in clinical practice: executive summary: Fourth Joint Task Force of the European Society of Cardiology and Other Societies on Cardiovascular Disease Prevention in Clinical Practice (Constituted by representatives of nine societies and by invited experts). Eur Heart J 28(19):2375-414

Perk J, De Backer G, Gohlke H, Graham I, Reiner Z, Verschuren WM, Albus C, Benlian P, Boysen G, Cifkova R, Deaton C, Ebrahim S, Fisher M, Germano G, Hobbs R, Hoes A, Karadeniz S, Mezzani A, Prescott E, Ryden L, Scherer M, Syvänne M, Op Reimer WJ, Vrints C, Wood D, Zamorano JL, Zannad F (2012) European guidelines on cardiovascular disease prevention in clinical practice (version 2012) : the fifth joint task force of the European society of cardiology and other societies on cardiovascular disease prevention in clinical practice (constituted by representatives of nine societies and by invited experts). Int J Behav Med 19(4):403-88

FDA (2011) FDA approves blood-thinning drug Brilinta to treat acute coronary syndromes. Boxed warning says daily aspirin doses above 100 milligrams decrease effectiveness. FDA News Release, published online at http://www.fda.gov/NewsEvents/Newsroom/ ... uncements/" onclick="window.open(this.href);return false; , retrieved 2013-04-09


Disclaimer:

I'm not a doctor. I'm a pharmaceutical sales representative with a Master's degree in NotMedicine, who's first language is NotEnglish. This is not medical advice. If you die because you follow it, tough luck. Screw you, I'm not taking responsibility for anything. Also, Krustofski owes me two beers.


Thank you for your time,
TODP.
Off the internet until further notice.

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Re: Heart attacks, aspirin and a small saga, reality check

Post by ZombieGranny » Tue Apr 09, 2013 2:05 pm

Thank you.
Enjoy your beers.
In my day, we didn't have virtual reality.
If a one-eyed razorback barbarian warrior was chasing you with an ax, you just had to hope you could outrun him.
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Preps buy us time. Time to learn how and time to remember how. Time to figure out what is a want, what is a need.

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Re: Heart attacks, aspirin and a small saga, reality check

Post by Vicarious_Lee » Tue Apr 09, 2013 2:06 pm

That's not just top-shelf posting, that's "Special Reserve" posting.

You know, the kind of post that's equivalent to those ornate, shiny bottles under soft lighting that they keep proudly displayed behind the center of the bar, and that are prohibitively expensive for all but the most special of occasions.

This post is the equivalent of that. I bet if you look up you can see the bottles I'm talking about wherever you two are sitting, right? As long as Krustofski's buying anyway. :awesome: :lol: :lol:

For real though, thanks for the info. :clap:
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Re: Heart attacks, aspirin and a small saga, reality check

Post by TODP » Fri Apr 19, 2013 2:42 pm

Vicarious_Lee wrote:That's not just top-shelf posting, that's "Special Reserve" posting.

You know, the kind of post that's equivalent to those ornate, shiny bottles under soft lighting that they keep proudly displayed behind the center of the bar, and that are prohibitively expensive for all but the most special of occasions.

This post is the equivalent of that. I bet if you look up you can see the bottles I'm talking about wherever you two are sitting, right? As long as Krustofski's buying anyway. :awesome: :lol: :lol:

For real though, thanks for the info. :clap:
I don`t fully understand what you are saying, but I think it`s a compliment. So thank you. :wink:

Thank you for your time,
TODP.
I am, and ever will be, a white-socks, pocket-protector, nerdy engineer -- born under the second law of thermodynamics, steeped in the steam tables, in love with free-body diagrams, transformed by Laplace, and propelled by compressible flow.
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