Tuesday, November 03, 2009

Aspirin, take it with a pinch of salt, and with food

Aspirin; what to do? Everyone is in a state of total discombobulation, and to make it worse, the Daily Mail confuses primary and secondary prevention:

Growing evidence in recent months has increased the view that giving aspirin for primary prevention - where patients do have symptoms of heart disease - is counter-productive.

Wrong! Wrong again, Daily Mail, just as you were about Hitler.

Here's the distillation of 30 years in the consulting room:

A 300mg tab of aspirin is estimated to make you leak 10ml of blood on average, so the 75mg dose may (or may not, since nothing is proven in science) make you leak half a tsp.

In my practice I saw very little ulceration caused by aspirin-type drugs, and I always strongly advised patients to take them in the middle of a meal, so the pill is less likely to release all its goodness at one point of the gut.

This is just an anecdote. I can find no peer-reviewed, randomised double blind cross-over trial to refute the hypothesis that I (and my colleagues) give good advice on taking with food,
(a) because it is impossible to double blind, and
(puts conspiracy theory hat on)
(b) the manufacturers of proton pump inhibitors (Omeprazone &c) would lose out.

If still undure, just make sure you get 5 portions of fruit and veg a day, (the Australians are on 10), aim for 30 minutes' puffing and sweating exercise a day.

Oh, and don't worry.

That's it, time's up.

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