Aspirin: The Magic Pill Americans Love Their ER
About half of Americans get health care in ER
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hen Americans need medical care, almost one in two people choose the emergency room, a new study reveals. “I was stunned by the results. This really helps us better understand health care in this country,” said physician David Marcozzi. He is an associate professor in the University of Maryland’s department of emergency medicine. “This research underscores the fact that emergency departments are critical to our nation’s health care delivery system,” Marcozzi said in a university news release. “Patients seek care in emergency departments for many reasons. The data might suggest that emergency care provides the type of care that individuals actually want or need, 24 hours a day,” he added. The analysis of data from several national sources showed that there were more than 3.5 billion emergency department visits, outpatient visits, and hospital admissions during the 1996 to 2010 study period. U.S. emergency department visits increased by nearly 44 percent over the 14-year period, the findings showed. Outpatient cases accounted for nearly 38 percent of visits, and inpatient care accounted for almost 15 percent of visits. In 2010, there were nearly 130 million emergency department visits, compared with almost 101 million outpatient visits and nearly 39 million inpatient visits, according to the report. Black Americans were much more likely to seek emergency department care than other racial/ ethnic groups. In 2010, black people used the emergency department almost 54 percent of the time. The rate was even higher for black people in cities, at 59 percent, the researchers said. The study also found that Medicare and Medicaid patients were more likely to use the emergency department. Certain areas of the country also appeared to have a fondness for the emergency room. Rates of emergency department use were much higher in the South and West — 54 percent and 56 percent, respectively — than in the Northeast (39 percent). The findings suggest that increasing use of emergency departments by vulnerable groups may be due to inequality in access to health care, the study authors noted in the news release. The study was published online recently in the International Journal of Health Services.
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Among other things, people use it to prevent heart attack, to fight headaches, relieve pain — a new study now shows it also reduces the risk of liver cancer for certain patients By Deborah Jeanne Sergeant
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our medicine cabinet likely holds a pill that reduces cancer risk, risk of heart attack, and acute damage during a heart attack. It also relieves aches and pains. Is there anything aspirin can’t do? The humble white pill seems to live up to Bayer’s claims that it’s a “wonder drug” on many levels. Recent research from Taiwan indicates that taking a low dose of aspirin daily may reduce risk of liver cancer for certain patients. Presented at The Liver Meeting hosted by the American Association for the Study of Liver Diseases in October, the research indicates that daily aspirin therapy appears to significantly reduce risk of liver cancer that’s related to hepatitis B. Current therapies, such as antiviral medicine, reduce liver cancer risk; however, the therapy is not appropriate for many hepatitis B virus patients. Prescribing aspirin could provide a more widely tolerated and inexpensive treatment. The Taiwan researchers reviewed data from patients seen between 1998 and 2012 as the basis for their study. They compared 1,553 patients receiving daily aspirin for a minimum of 90 days with 6,212 patients who never did. The cases of liver cancer in the treated group proved markedly lower than the control group in five years. Further clinical research will be needed to confirm the initial findings. Kirsten Moysich, PhD, distinguished professor of oncology, departments of cancer prevention and control and immunology at Roswell Park Cancer Institute, led a study on the effects of aspirin in cancer patients, “Aspirin and Acetaminophen Use and the Risk of Cervical Cancer.” “Compared to nonusers, frequent aspirin use was associated with decreased odds of cervical cancer,” the study results stated. “A slightly larger association was observed with frequent, long-term use of aspirin. Acetaminophen use was not associated with the risk of cervical cancer.” The research suggested that “frequent and long-term use of aspirin is associated with decreased odds of cervical cancer.” The study included patients with cervical cancer and controls — women suspected of having but not ultimately diagnosed with a neoplasm. Patients taking aspirin at least once weekly for more than six months, up to daily tablets for more than five years, experienced a 47 to 54 percent reduced risk of cervical cancer. The study further stated, “These findings warrant further investigation in a larger sample size to characterize better the subset of frequent, long-term users, with better-defined dosing regimens, and information on HPV status,
screening practices, and cervical cancer histology.” While the research appears promising, Moysich advises women to obtain regular Pap smears, “which is the most effective way to detect cervical lesions before they are even cancerous,” she said. “There is strong evidence that regular aspirin use protects against cardiovascular disease and colon cancer,” she added. “There is growing evidence that regular aspirin use protects against breast cancer, endometrial cancer, lung cancer and head and neck cancer; however, individuals should consult with their physician to determine if an aspirin regimen is right for them.” William M. Healy, a Williamsville-based physician who offers personalized medical care throughout Western New York through MDVIP, said that research indicates daily aspirin may reduce the risk of colorectal cancer. “If you read guidelines, it takes five to 10 years before you have benefit from taking daily aspirin,” Healy added. Patients beginning at age 50 would receive benefit by age 60. “For breast cancer and cervical cancer, it didn’t show a benefit,” Healy said. For decades, aspirin has been used to reduce heart attack risk. Healy said that he recommends an aspirin a day — usually 81 mg. — if a patient has experienced a heart attack and is not contraindicated. “If they have lots of risk factors, it may be worth taking aspirin daily to prevent a heart attack,” Healy said. Risk factors may include high blood pressure, family history of heart problems and diabetes. Taking an aspirin acts as a sort of first aid for heart attack. People experiencing a heart attack can also experience less heart damage by taking aspirin. Many times during a heart attack, small bits of plaque in an artery break loose and partially clog the blood vessel. Platelets signal the blood to clot. The clot can completely block the rest of the artery. A dose of 325 mg. of uncoated aspirin helps protect the heart from damage by inhibiting those platelets from forming clots, thus buying time for physicians to physically clear the blockage or use clot-busting drugs. How the patient takes aspirin makes a difference. Swallowing an aspirin whole slows its benefit, since it needs more time to enter the blood stream. Chewing the aspirin takes less time-only five minutes-to begin
IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • December 2017
providing benefit, compared with 12 minutes for swallowed aspirin. Patients should discuss their health concerns with their health care provider before taking daily aspirin or making any other changes with medication.
12 Things You Need to Know About Aspirin In “12 Things You Should Know About Aspirin” (US News & World Report: Oct. 28, 2017), writer Sarah Baldauf listed a few of aspirin’s emerging benefits and a few caveats, summarized below: Aspirin can: 1) Cut pre-eclampsia risk during pregnancy. 2) Reduce risk of developing colorectal cancers. 3) Lower a woman’s risk of breast cancer. 4) Throw off test results for prostate cancer. 5) Offer some protection against Alzheimer’s disease. 6) Help prevent strokes—unless you also take ibuprofen 7) Prevent asthma in middleaged women. 8) Protect against Parkinson’s disease. 9) Provide zero protection against heart attacks in people with diabetes. 10) Offer no protection to sufferers of heart attack or stroke who are “aspirin resistant.” 11) Cause stomach troubles such as gastrointestinal bleeding and stomach ulcers—particularly with long-term use of the drug. 12) Be less effective in women.