Daily ‘Baby Aspirin’: FDA now says risks may outweigh benefits

FDA’s New Position on Daily ‘Baby Aspirin’

Growing up I heard repeatedly the importance of taking a low-dose daily aspirin (i.e. baby aspirin) to prevent heart attack. If you grew up with the same story, the FDA’s 2014 change of position might come as a surprise, if you haven’t already heard it. In their Consumer Update, they wrote:

“…, [A]fter carefully examining scientific data from major studies, FDA has concluded that the data do not support the use of aspirin as a preventive medication by people who have not had a heart attack, stroke or cardiovascular problems, a use that is called ‘primary prevention.’ In such people, the benefit has not been established but risks—such as dangerous bleeding into the brain or stomach—are still present.”

Special concern applies to anyone already taking other blood thinners, such as warfarin, dabigatran (Pradaxa), rivaroxaban (Xarelto) and apixiban (Eliquis).

Should everyone avoid taking baby aspirin?

In short, no. Dr. Robert Temple, deputy director for clinical science at the FDA at the time emphasizes, “Since the 1990s, clinical data have shown that in people who have experienced a heart attack, stroke or who have a disease of the blood vessels in the heart, a daily low dose of aspirin can help prevent a reoccurrence.” How do you know which is appropriate for you? Talk to your primary care physician.

What are my alternatives?

The common denominators are always proper diet and establishing healthy eating habits, exercise, maintain a healthy blood pressure, quit smoking if you haven’t already, and stress reduction. Did you know acupuncture can help with almost all these efforts? To learn more, consider reading, “Give Your Cardiovascular Health a Boost with Acupuncture.” Additionally, establishing a daily meditation routine can do wonders. Not convinced? Consider a 2012 study, that found “African Americans with heart disease who practiced Transcendental Meditation regularly [twice daily for 20 minutes] were 48 percent less likely to have a heart attack, stroke or die from all causes compared with African Americans who attended a health education class over more than five years.” I’d say that sounds worth it. Would you?

 

Good Sun, Bad Sun

The sun’s not the only who gets spots. So what’s the story, anyway? We need sun exposure for vitamin D production, indicated for everything from bone loss/fracture to heart, pulmonary, and skin disease–heck, you name it, and you’ll probably find a correlation! In fact, no more than about 20% of our vit. D comes from food sources such as fish and fortified foods; the rest comes from the sun. And sorry folks of color – you’re at higher risk of deficiency. Between 2001 and 2006, the National Health and Nutrition Examination Surveys, found that as much as almost 75% of blacks were showing inadequate or deficient levels of the vitamin (yikes!). But with more and more information available about damage from the sun’s rays, our culture has gone from sun bathing to sun scathing. Everyone is asking, “What’s the safest way to protect oneself and stay healthy?”

The most important thing I learned only within the last two years (if you’d believe it took that long!) is that there’s actually two types of sunscreens – chemical and physical. Chemical sunscreens (e.g. avobenzone, octinoxate, oxybenzone, etc) actually get absorbed into the skin, where they then absorb incoming UV rays before they damage your skin. Physical, or mineral (such as titanium dioxide or zinc oxide), sunscreens sit on top of the skin where they deflect the rays. Now seeing as we absorb about two-thirds of what’s put on the skin, it may be interesting to note that cosmetic UV filters were found in 85% of human milk sampled from Swiss mothers between 2004-2006. (Whoa!) These are the same chemicals found in mice to actually disrupt hormones. While it may not be worth getting your panties all up in a bunch–people are still on either side of the bench as to whether or not these chemicals have the potential to actually increase your risk for cancer–I can’t help but ask, is it really worth the risk?

Mineral sunscreens get their load of bad rap too. The main argument is against nanoparticles which some argue are toxic to humans and the ecosystem. Specifically, nano-titanium dioxide has been shown when inhaled (i.e. not applied topically) to show pulmonary inflammation as bad as that induced by asbestos. Others argue that zinc oxide is photoreactive, and can cause free radical damage to the skin. (Badger does a good job of explaining these arguments in detail.) While the first argument is easy to get around – there are plenty of mineral sunscreens that do not use nanotechnology – there is something to the last argument. How effective added antioxidants are to a sunscreen is a little up for grabs; but certainly I’d much rather go with this class of sunscreen than dumping yet more chemicals into my body and sewer.

A lot of people ask, “What about sunscreen in a facial moisturizer?” Almost inevitably, these sunscreens are your typical chemical sunscreen. And what’s worse – is most of the time folks put moisturizer first thing in the morning and perhaps again at night, but only go out in the sun in the afternoon. All that chemical absorbed for absolutely no good reason! The FDA has even stated companies can no longer claim products to be “waterproof,” “sunblock,” or “sweatproof” simply because people aren’t applying their sunscreen often enough for them to be effective (a “water-resistant” product will only be effective for 40 – 80 minutes). So, I encourage folks to use sunscreen as sunscreen, when you need it. The NIH suggests 5 – 30 minutes of sun exposure between 10 AM and 3 PM at least twice a week to the exposed areas without sunscreen for sufficient vitamin D production; given this, consider how often are you in sun and during what hours to get a better idea of how often you’ll need to apply and *reapply* sunscreen.

Lastly, [your word here] bless the simplicity of a hat and long sleeves! Be fashionable, and comfortable while saving your skin. While I was down in Australia, I used something like this — saved me big time!

PS. Always look for products that offer broad-spectrum coverage. Interested to learn more about safety ratings? Try the EWG Cosmetic Database.

PPS. On the subject of the vitamin D and its role in bone health, Liz Smith of Medical Integration Services will be conducting affordable and easy bone density tests at Met Market in Queen Anne on June 15th (Fri) 3 – 7p and June 16th (Sat) 11 – 2p.