So a few things to know about health science.
- Science as a whole is complicated and rarely conveyed well through half-glimpsed headlines. Popular media uses flashy headlines and forceful stories to assert stuff; stories that say that there are new indications of hints of trends of possible explanations for future consideration either don’t get written or are punched up to be read as more definitive.
- Health science is really complicated, largely because we frown on human experimentation and therefore have to observe things much more indirectly and over time. Further, there’s no such thing as perfect health (no matter how many people want to sell you a pill or diet for it), just trying to optimize the battle against biological entropy.
- There are few absolutes in health science, because every individual case has variations — genetics, lifestyle, environmental factors, medical history. The recommendation to “talk with your doctor” isn’t just advertising-speak; it’s an acknowledgement that broad truisms and “guidelines” only go so far, and that everything is a speculative cost-benefit exercise. It’s like tax advice, only a zillion times more complex.
- Science in general is an ever-evolving body of knowledge. It’s not that things are “true” one day and “false” the next, or that scientists are constantly changing their minds, it’s just that what is known, what connections are made, is constantly advancing, the picture becoming less unclear over time.
So over the weekend we got blaring headlines saying “Doctors now say don’t take aspirin to avoid strokes, heart attacks.” Which can lead people to either roll their eyes at how “those doctors are always changing their minds,” or else a panic that “I’ve been doing it wrong and now I’m going to die!”
Neither is the case.
Even digging just a bit below the headlines indicates that the reason the guidelines have changed. Low dosage aspirin, for example, has always carried a certain level of risk (from bleeding, for example), but (as health science is always about compromises) that risk was considered offset by incremental reductions in risk of stroke and heart attack.
But now there are identified better and less-risky ways of addressing those stroke and heart attack chances — a preference for exercise and diet, use of statin medications, etc. Given that, taking an aspirin a day becomes less beneficial compared to its risks, in some cases, and so, in some cases, is no longer recommended.
It’s really about that simple.
And even that’s not an absolute. The guideline changes are for older adults without a history of or a high risk for heart disease. Doctors previously, for that population, might have suggested a children’s aspirin daily just to avert future problems. Now they probably won’t. But they might still if there are existing or potential conditions — past strokes, heart attacks, stents, open-heart surgery — because, again, the risk equation is different at that point, with the observed benefit for those populations outweighing known aspirin risks.
These are also not tablets (so to speak) passed down from the heavens; these are recommendations from the American Heart Association and the American College of Cardiology. Guidelines from other organizations may (and do) vary.
So, don’t lose faith in the medical profession; for all its flaws and human characteristics, it’s still the best game in town. Read past the headlines for more information than has been thrown out there to gather clicks and eyeballs. And, of course, “talk with your doctor” before making any sort of change (though maybe don’t bug them Day 1 of new guidelines coming out, because they’re still trying to digest and evaluate what it all means, too).
Do you want to know more? Daily low-dose aspirin no longer recommended as heart attack preventative for healthy adults – CNN (which, in all fairness, is not a bad headline to sum it all up)