Aspirin, CVD Risk, & Potential Counter-Risks

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In A Rush?

Today’s 30-Second Summary

If you don’t have time to read the whole email today, here are some key takeaways:

• Many people take low-dose aspirin to reduce CVD risk; is this a good idea or bad?

  • Today’s main feature weighs the benefits against the risks

  • We talk CVD and gastrointestinal tract bleeding, as well as potential liver and kidney issues

• As we age, our collagen levels tend to get depleted more easily. Collagen is important not just for youthful good looks, but also for the health of bones and joints

  • Today’s sponsor NativePath are offering high-quality collagen without additives or harmful impurities

• Today’s featured recipe is a polyphenol-plentiful paprika pepper penne pasta, that’s as full of flavor as it is full of antioxidants!

Read on to learn more about these things, or click here to visit our archive

A Word To The Wise

Watch and Learn

How to Fall Asleep Faster: CBT-Insomnia Treatment

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Mythbusting Friday

Aspirin Pros & Cons

In Tuesday’s newsletter, we asked your health-related opinion of aspirin, and got the above-depicted, below-described set of responses:

• About 42% said “Most people can benefit from low-dose daily use to lower CVD risk”

• About 31% said “It’s safe for occasional use as a mild analgesic, but that’s all”

• About 28% said “We should avoid aspirin; it can cause liver and/or kidney damage”

So, what does the science say?

Most people can benefit from low-dose daily aspirin use to lower the risk of cardiovascular disease: True or False?

True or False depending on what we mean by “benefit from”. You see, it works by inhibiting platelet function, which means it simultaneously:

• decreases the risk of atherothrombosis

• increases the risk of bleeding, especially in the gastrointestinal tract

When it comes to balancing these things and deciding whether the benefit merits the risk, you might be asking yourself: “which am I most likely to die from?” and the answer is: neither

While aspirin is associated with a significant improvement in cardiovascular disease outcomes in total, it is not significantly associated with reductions in cardiovascular disease mortality or all-cause mortality.

In other words: speaking in statistical generalizations of course, it may improve your recovery from minor cardiac events but is unlikely to help against fatal ones

The current prevailing professional (amongst cardiologists) consensus is that it may be recommended for secondary prevention of ASCVD (i.e. if you have a history of ASCVD), but not for primary prevention (i.e. if you have no history of CVD). Note: this means personal history, not family history.

(ASCVD = atherosclerotic cardiovascular disease, specifically)

In the words of the Journal of the American College of Cardiology:

Read in full: Guideline on the Primary Prevention of Cardiovascular Disease: A Report of the American College of Cardiology

Or if you’d prefer a more pop-science presentation:

Many older adults still use aspirin for CVD prevention, contrary to clinical guidance

Aspirin can cause liver and/or kidney damage: True or False?

True, but that doesn’t mean we must necessarily abstain, so much as exercise caution.

Aspirin is (at recommended doses) not usually hepatotoxic (toxic to the liver), but there is a strong association between aspirin use in children and the development of Reye’s syndrome, a disease involving encephalopathy and a fatty liver. For this reason, most places have an official recommendation that aspirin not be used by children (cut-off age varies from place to place, for example 12 in the US and 16 in the UK, but the key idea is: it’s potentially dangerous for those who are not fully grown).

Aspirin is well-established as nephrotoxic (toxic to the kidneys), however, the toxicity is sufficiently low that this is not expected to be a problem to otherwise healthy adults taking it at no more than the recommended dose.

For numbers, symptoms, and treatment, see this very clear and helpful resource:

An evidence based flowchart to guide the management of acute salicylate (aspirin) overdose

Take care!

Our Sponsors Make This Publication Possible

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This Or That?

Vote on Which is Healthier

Yesterday we asked you to choose between macadamia nuts and Brazil nuts— we picked the Brazil nuts (click here to read about why), as did 67% of you!

Now for today’s choice:

Click on whichever you think is better for you!

Recipes Worth Sharing

Polyphenol Paprika Pepper Penne

This one's easier to promptly prepare than it is to pronounce unprepared! Ok, enough alliteration… This dish is as full of flavor as it is full of antioxidants, and it's great for digestive health and heart health too:

Click below for our full recipe, and learn its secrets:

One-Minute Book Review

Adult Children of Emotionally Immature Parents: How to Heal from Distant, Rejecting, or Self-Involved Parents – by Dr. Lindsay Gibson

Not everyone had the best of parents, and the harm done can last well beyond childhood. This book looks at healing that.

Dr. Gibson talks about four main kinds of “difficult” parents, though of course they can overlap:

1. The emotional parent, with their unpredictable outbursts

2. The driven parent, with their projected perfectionism

3. The passive parent, with their disinterest and unreliability

4. The rejecting parent, with their unavailability and insults

For all of them, it’s common that nothing we could do was ever good enough, and that leaves a deep scar. To add to it, the unfavorable dynamic often persists in adult life, assuming everyone involved is still alive and in contact.

So, what to do about it? Dr. Gibson advocates for first getting a good understanding of what wasn’t right/normal/healthy, because it’s easy for a lot of us to normalize the only thing we’ve ever known. Then, beyond merely noting that no child deserved that lack of compassion, moving on to pick up the broken pieces one by one, and address each in turn.

The style of the book is anecdote-heavy (case studies, either anonymized or synthesized per common patterns) in a way that will probably be all-too-relatable to a lot of readers (assuming that if you buy this book, it’s for a reason), science-moderate (references peppered into the text; three pages of bibliography), and practicality-dense—that is to say, there are lots of clear usable examples, there are self-assessment questionnaires, there are worksheets for now making progress forward, and so forth.

Bottom line: if one or more of the parent types above strikes a chord with you, there’s a good chance you could benefit from this book.

Click here to check out Adult Children of Emotionally Immature Parents, and rebuild yourself!

Penny For Your Thoughts?

May today see you well-prepared for the coming weekend,

The 10almonds Team