The Aspirin Controversy, Part II

My post last week created much confusion and worry.  I received many emails asking “What about me?  Should I keep taking aspirin or not?” Let me clarify the issue by explaining what we already knew before last week’s study in the British Medical Journal.  We knew that aspirin is valuable in:
  • patients who have had a stroke
  • patients who have had a heart attack
  • patients who have had bypass surgery or angioplasty
  • patients with angina (chest pain or d...
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Aspirin Doesn’t Prevent Heart Attacks in Patients with Diabetes

Aspirin has been a mainstay in the treatment and prevention of cardiovascular disease for decades. We know that in patients who have had a heart attack in the past aspirin prevents a second heart attack, and during a heart attack aspirin is life-saving.  We also know that in patients with a prior stroke aspirin prevents further strokes.  And in patients with symptomatic narrowing of the arteries, that is chest pressure with exertion (angina) or calf pain with walking (claudication), aspirin pre...
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Take a Big Breath

I beg your indulgence this week as I ignore medical news and offer some personal reflections. Unless you’ve been avoiding all news sources for the last few weeks, you know that a lot of people all over the world are scared.  Today’s headlines scream about the worst week ever on Wall Street, with trillions of dollars of assets evaporating.  No one is sure when the housing and credit markets will stop falling.  No one is sure whether the actions of the U.S. and other governments to keep credit fl...
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Medications for Osteoporosis

The current issue of the Annals of Internal Medicine published a clinical practice guideline from the American College of Physician on drug treatment for low bone density.  It contains a valuable review of the known benefits and risks of the medications used for osteoporosis which I summarize below. Bisphosphonates This family of medicines includes Fosamax, Didronel, Boniva and Actonel.  Fosamax, Didronel, Boniva and Actonel have been proven to prevent vertebral fract...
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