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Aspirin: Should the government make Americans take it?

Published: Thursday, Dec. 13 2012 9:06 a.m. MST

During the past two weeks, a roiling decade-long debate regarding the efficacy of the drug aspirin as a preventative measure against heart attacks and cancer has prominently resurfaced in the United States and England.

On Wednesday, USC medical professor David B. Agus penned an op-ed piece for the New York Times headlined “The 2,000-Year-Old Wonder Drug” in which he boldly called for low-dose aspirin regimens to be mandatory for middle-aged Americans.

Agus wrote, “In the endless debate about ‘health care reform,’ few have zeroed in on the practical actions we should be taking now to make Americans healthier. … When the scientific data clearly and overwhelmingly demonstrate that one behavior or another can substantially reduce — or, conversely, raise — a person’s risk of disease … encouraging a healthy behavior, or discouraging an unhealthy one, ought to be a matter of public policy — which is why, for instance, we insist on vaccinating children for the measles, mumps, rubella and polio; we know these preventive strategies save lives.

“Under that rationale, then, why not make it public policy to encourage middle-aged people to use aspirin?”

Throughout Wednesday, the Agus article sat atop the list of most emailed articles on the New York Times website.

Also Wednesday, the British newspaper The Telegraph broke news about potential changes to aspirin policy in Great Britain: “The Government gave its clearest signal yet that it is ready to use aspirin to tackle the disease in its latest annual review of cancer treatment. … A recent study, published in the Journal of the National Cancer Institute, showed people who had taken aspirin at least once a month in the past year were 49 percent less likely to develop the most common form of liver cancer. Scientists have been working on an international statement on using aspirin to prevent cancer, and the Department of Health signaled in the report it was ready to accept their recommendations.”

Back on Dec. 4, the New York Times’ Katie Thomas summarized the significance of a new study published in the scientific journal Circulation: “A commonly used coating to protect the stomach may obscure the benefits (of aspirin), leading doctors to prescribe more expensive prescription drugs. … For more than a decade, cardiologists and drug researchers have posited that anywhere from 5 to 40 percent of the population is ‘aspirin resistant,’ as the debated condition is known. But some prominent doctors say that the prevalence of the condition has been exaggerated by companies and drug makers with a commercial interest in proving that aspirin — a relatively inexpensive, over-the-counter drug whose heart benefits have been known since the 1950s — does not always work.”

Thomas revisited the aspirin issue Monday with a piece headlined, “Coating on Aspirin Sets Off a Debate,” that mainly summarized the main points of her previous aspirin article.

The trade website Pharmacy Times advises pharmacists to “encourage patients to assess their cardiovascular risk factors with their primary health care providers before starting low-dose aspirin therapy, because its risks and benefits vary from individual to individual. This is particularly critical if the patient has other medical conditions or is currently taking any other medications, including alternative medications or supplements. Before recommending low-dose aspirin therapy, it is imperative for pharmacists to assess the patient’s allergy history and concurrent medical and medication history in order to screen for potential contraindications and drug interactions.”

Jamshid Ghazi Askar is a graduate of BYU's J. Reuben Clark Law School and member of the Utah State Bar. Contact him at jaskar@desnews.com or 801-236-6051.

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