Do You Need To Take Baby Aspirin or Blood Thinners?

Suzypenguin yikes I have a clotting autoimmune condition well interestingly enough I'm gonna go ahead and give you the punchline that clotting discussion one of the things that's coming up and several people are considering you know by the time we know that somebody's got COVID-19 from coronavirus infection maybe we should go ahead and start covering them with uh blood thinners anti-clot mechanism well guess what I'm already on it why am I on it I'm on Eliquis you know you see Eliquis Xarelto you see some of those medicines here's why so many people are on it the number one cause or the number one cardiac dysrhythmia or arrhythmia is what people used to call it but that arrhythmia means no rhythm you got to have rhythm or you won't be alive dysrhythmia means not such a good rhythm number one dysrhythmia is what I've got it atrial fib and here's one of the things we used to think that cryptic or stroke of unknown origin well then we're beginning to find all those strokes of unknown origin and by far the majority of strokes were used to be "unknown" origin we're finding out are due to atrial fib atrial fib like I've got which is called paroxysmal atrial fib fibrillation which means your heart's beating at a normal pace on a regular basis but then it'll go into atrial fibrillation on and you know it may go into 15 second run of atrial fib well these unnoticed runs of atrial fib appear to be enough to cause clots so if you have paroxysmal atrial fibrillation you probably don't know it just like that 90% of people that have prediabetes don't know it and if you have it if you have atrial fib your probability of having a stroke has just gotten multiplied by five to seven times and again you don't know it now most people that have atrial fib at least most baby boomers once you get to that age probably need to be on one of these anti-clotting mechanisms so like they're called NOACs new or novel oral anticoagulants again the most common ones are Rivaroxaban or Xarelto and eliquis like I'm on so again maybe i'm jumping around a little bit but it's an important concept again another hugely neglected area in terms of health of baby boomers Dave Murphy what are your thoughts on low dose aspirin you know there was the ASPREE trial A-S-P-R-E-E and a couple of others about 12 to 18 months ago and the interpretation that came out of these free trials was a low-dose aspirin is not indicated anymore it didn't really help well that was wrong in my book I don't agree with it and I think it's related to the fact that doctors for the most part today tend to practice prevention from you know it's a cardiologist who's primarily a cardiologist and remembers a few things about prevention and just tries to apply that or a family practitioner or whatever I know I'm being a preventive medicine snob but here's the thing I think we do a lot of people a lot of disservice not knowing and thinking through the details I appreciate you bringing this up Dave so what you saw with this ASPREE trial was this there was a lower amount of benefit and obviously the same amount of risk you know there's nothing that's risk-free especially aspirin if our in the FDA I'd rather than go back and make metformin non-prescription and especially the Freestyle Libre non-prescription but then turn around and make aspirin prescription because aspirin has some risks now what they showed in this ASPREE trial is that the benefits for people taking baby aspirin were not as high anymore and that was because we've made progress now despite the fact that heart attack and stroke is still the major causes of death and disability even in the age of COVID by the way that's what the early numbers prior to the show mean even with that we've made progress we're better than we were 10 years ago and 20 years ago when the original baby aspirin studies were done so therefore the interpretation was we don't think you need to take baby aspirin anymore well here's the problem and here's where we weren't thinking the standards committees I think we're not thinking I know they're thinking but I don't agree with them the standards committees before they were saying if you turn age what 55 60 you should start taking baby aspirin well i understand why they said that i mean that's when you start getting into the risk age for heart attack and stroke but what about the people that have no plaque if you have no plaque why would you be taking baby aspirin where else do we see that question we make the same kind of assumption if you have a an LDL level over 120 or over 100 and some people are even saving over 70 then you need to be taking a statin if you've got no plaque you don't need to be taking a statin and you know don't need to be taking a baby aspirin so if you go back and you rewrite those standards and say look unless you have plaque you don't take that or baby aspirin then all of a sudden the vast majority of the statin prescriptions would go away and the vast majority of the aspirin prescriptions would go away the people that are left are the people that have non-plaque if you've got known plaque your risk for heart attack and stroke is much higher than somebody that doesn't at that point i do think you need to be taking baby aspirin but the bottom line is this for people that have plaque I think you need to be on a blood thinner either low dose baby aspirin 81 milligrams daily you also by the way are in that risk category at that point if you have plaque you're also in the risk category to have the other chronic diseases like high blood pressure and by the way unrecognized paroxysmal atrial fibrillation so I think you need to rule that out if you have atrial fibrillation aspirin doesn't work as well you need at that point to be on one of the NOACs novel oral anticoagulants like Eliquis or Xarelto continue to get great feedback regarding the webinars and here's why you know on the Internet when you hear a webinar you expect for somebody to try to sell you something we're not doing that we're trying to tell you something people are coming in with their labs from Quest inflammation panel OGTT insulin survey response and then they're finding out do I have inflammation do I have insulin resistance and where does that fit in terms of other folks we're getting ready to start one for CIMT as well so again people are really excited about finding out their own status looking forward to seeing you there thanks

Channel: PrevMed Health

Views: 26,328

Keywords: blood thinners, aspirin, baby aspirin benefits, baby aspirin for heart, atrial fibrillation, heart attack, aspirin and strokes, stroke prevention, blood clot, anticoagulants, xarelto, eliquis, noacs, covid-19 clotting, covid 19 blood clotting, covid 19 clotting issues, q&a, prevmedheartrisk, ford brewer prevmed, drfordbrewer, prevmed, heart attack and stroke prevention, preventive medicine, yt:cc=on, baby aspirin, aspree trial

Id: 00zy0NERlYw

Length: 8min 2sec (482 seconds)

Published: Fri Aug 21 2020