Use of Aspirin Continues to Rise in Older Generations
A national survey suggests that slightly more than half of the older adults in the United States are now taking a daily dose of aspirin, even though its use is not recommended by the Food and Drug Administration for most people who have not yet had a heart attack or stroke.
The analysis was published in the American Journal of Preventive Medicine. It observed that aspirin use is continuing to surge, especially among adults who are using it for “primary prevention,” meaning in order to prevent an initial cardiovascular event, and in some cases to prevent cancer.
In this survey of more than 2,500 respondents aged 45-75, 52 percent reported current aspirin use, and another 21 percent had used it at some point in the past. The average age of respondents in the survey was 60. A different report found that aspirin use increased 57 percent between 2005 and 2010.
Aspirin is a blood thinner and can cause bleeding events, which is a primary reason some medical experts recommend caution in its use, even at the “baby aspirin” dose of 81 milligrams often used for disease prevention. The FDA has determined that in primary use to prevent a first heart attack or stroke, for every such event that’s prevented, there’s approximately one major bleeding event that’s caused, such as gastrointestinal bleeding.
Largely on that basis, they have concluded physicians should routinely recommend its use only to patients that have already had a heart attack or stroke. But this study found that 81 percent of older adults who are now using aspirin have not had a heart attack or stroke, and are taking it for primary prevention.
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“The use of aspirin is still a very contentious issue among medical experts,” said Craig Williams, a pharmacotherapy specialist with the College of Pharmacy at Oregon State University, and lead author of the new report.
“There’s no doubt that aspirin use can have value for people who have experienced a first heart attack, stroke or angina,” said Williams, a professor in the Oregon State University/Oregon Health & Science University College of Pharmacy. “The data to support that is very strong. The support of its use in primary prevention is more of a mixed bag.
“But this survey clearly shows that more and more people who have not experienced those events and are not technically considered at high risk by the FDA are also deciding to use aspirin, usually in consultation with their doctors.”
Aside from cardiovascular events, some studies have suggested a role for aspirin in preventing cancer, Williams said, especially colon cancer. That has further increased interest in its use, he said.
While the FDA takes a more cautious stance, Williams said, some other professional organizations, such as the U.S. Preventative Services Task Force, says aspirin use may be appropriate for primary prevention in people with serious risk factors for cardiovascular disease, such as high blood pressure, high cholesterol, smoking or diabetes. Objective criteria for aspirin use in those patients are based on the number of the risk factors, the age and gender of the patient.
Surveys such as this are needed to help determine how people are managing their own health, Williams said, since aspirin is an over-the-counter medication and its use cannot be determined solely by medical records. And the findings suggest that tens of millions of Americans have reviewed the issues involved, often discussed it with their doctors, say they know what they are doing - and decided to use aspirin.
Among the findings of the report:
- Several markers of healthy lifestyle choices were also associated with aspirin use.
- The strongest predictor of regular aspirin use was a patient having discussed aspirin therapy with a health care provider.
- About 35 percent of people who don’t objectively have risk factors that might merit aspirin therapy still use it.
- About 20 percent of people who have already had a heart attack or stroke, and should be on aspirin therapy, do not use it.
- A majority of both current and previous aspirin users rated themselves as being somewhat or very knowledgeable about it.
- Among aspirin users, the reasons cited for its use by respondents was for heart attack prevention, 84 percent; stroke prevention, 66 percent; cancer prevention, 18 percent; and prevention of Alzheimer’s disease, 11 percent.
- Significant predictors of aspirin use included people who were physically active, ate healthy foods, had achieved a healthy weight, managed their stress, tried to quit smoking, and/or had undergone health screenings.
This study was sponsored by the Partnership for Prevention and the Council on Aspirin for Health and Prevention. This council receives financial support from Bayer HealthCare, which has no influence over its programs or activities, and played no role in the decision to conduct this research or publish the results.
Collaborators with Oregon State University on the research were from Harvard/Brigham and Women’s Hospital; the Partnership for Prevention; The Ohio State University; the University of North Carolina; and Stanford University.
How healthcare can safeguard itself against cyberthreats
One of the most fundamental lessons from the COVID crisis is that health should always be a priority. In a similar fashion to the human body that frequently fights off viruses and foreign invaders that intend to cause it harm, the sector itself is now a prime target for another type of external threat: cyberattacks.
The figures speak for themselves: between December and January this year, hospitals in the UK were at 89% capacity, with 7,000 fewer available beds than there usually are. As the pandemic increased pressure on hospitals, clinics, and research facilities to create a treatment for patients globally, it has left the sector exposed to hackers who, like a virus, have been targeting it relentlessly and evolving their tactics.
From patient records being held ransom, to fake emails claiming to originate from the UN WHO, the NHS, or vaccine centres, through to attacks on the cold supply chain to find out the secret formula of the COVID vaccine, the healthcare industry is facing constant cyberattacks and struggling to cope. This threat is unlikely to go away anytime soon – and as such, the industry needs to take a proactive, preventative stance to stay safe in a dynamic digital world.
The responsive nature of healthcare – particularly of hospitals – means that efficiency is crucial to the industry’s standard operations. To support this, the sector has been embracing technological advancements that can improve the quality of work, enabling staff to meet pressing deadlines, and enhancing patient care. For example, the industry has been digitising records and improving its ways of working through digital means over the past few years.
This shift is critical to offer high quality patient care; yet, it also means the sector has become more dependent on IT, which can come with a risk if cybersecurity processes employed are deemed as inadequate.
Without the correct security measures in place, the desired efficiency gains realised, can be easily lost in a heartbeat. Simply put, an elementary glitch in the system can have a tremendous ripple effect on many areas, from accessing patient records and conducting scans, to maintaining physical security and protecting the intellectual property of experimental treatment development.
To prevent this, healthcare organisations need to ensure they’re considering cybersecurity as part of their overall digital transformation strategy – and setting the right foundations to create a culture where safety goes hand in hand with patient care.
Before implementing cybersecurity process, healthcare organisations need to assess the potential risks they face. Depending on how much confidential data the trust has, where it is stored, who has access to it and via which means, the cybersecurity strategy and associated solutions will change.
It’s fair to say that a medical device start-up where all employees have a corporate-sanctioned laptop and access data via a VPN will have radically different needs to a large hospital with hundreds of frontline workers connecting to the hospital’s Wi-Fi using their personal device.
These requirements will pale by comparison to a global pharmaceutical giant with offices in multiple locations, a large R&D department researching new treatments for complex diseases and a fully integrated supply chain. Considering the existing setup and what the organisations is looking to achieve with its digital transformation strategy will therefore have an immediate impact on the cybersecurity strategy.
Despite this, there are fundamentals that any organisation should implement:
Review and test your back-up policy to ensure it is thorough and sufficient – By checking that the organisation’s back-up is running smoothly, IT teams can limit any risks of disruption in the midst of an incident and of losing data permanently.
In our recent State of Email Security report, we found that six out of ten organisations have been victims of ransomware in 2020. As a result, afflicted organisations have lost an average of six days to downtime. One third of organisations even admitted that they failed to get their data back, despite paying the ransom. In the healthcare industry, this could mean losing valuable patient records or data related to new treatments – two areas the sector cannot afford to be cavalier about.
Conduct due diligence across the organisation’s supply chain – Healthcare organisations should review their ways of working with partners, providers and regulatory institutions they work with in order to prevent any weak link in their cybersecurity chain. Without this due diligence, organisations leave themselves exposed to the risks of third party-led incidents.
Roll out mandatory cybersecurity awareness training - Healthcare organisations shouldn’t neglect the training and awareness of their entire staff – including frontline workers who may not access the corporate network on a regular basis. According to our State of Email Security report, only one fifth of organisations carry out ongoing cyber awareness training.
This suggests it is not widely considered as a fundamental part of most organisations cyber-resilience strategy, despite the fact many employees rely on their organisation’s corporate network to work. By providing systematic training, healthcare organisations can help workers at all levels better understand the current cyberthreats they face, how they could impact their organisation, the role they play in defending the networks, and develop consistent, good cybersecurity hygiene habits to limit the risks of incidents.
Consider a degree of separation – Information and Operational Technology (IT and OT) networks should be separated.
Although mutually supported and reliance on each other, employees shouldn’t be accessing one via the other. This should be complemented by a considered tried and tested contingency and resiliency plan that allows crucial services to function unabated should there be a compromise. Similarly, admin terminals should not have internet access to afford a degree of hardening and protection for these critical accounts.
As the sector becomes a common target for fraudulent and malicious activity, putting cybersecurity at the core of the organisation’s operations is critical. It will help limit the risks of disruption due to cyberattacks, reduce time spent by the cybersecurity team to resolve easily avoidable errors, and ensure that institutions can deliver patient care, safe in the knowledge that their networks are safe.
Fighting future threats
With technology continuing to change the face of healthcare, the surface area and vectors available for attacks by malicious actors is constantly increasing. With the introduction of apps, networked monitoring devices, and a need for communication, the attack vector is ever expanding, a trend that needs to be monitored and secured against.
To prevent any damage to patients, staff, or the organisation they are responsible for, healthcare leaders must put security front and centre of their digital transformation strategy. Only then can the sector harness the full benefits of technology. Doing this should include implementing cybersecurity awareness training to challenge misconceptions around security, encourage conversation, and to ensure employee knowledge of the security basics and threats faced.
This ultimately allows healthcare organisations to do what they do best: provide the highest standard of patient care, safe in the knowledge that their operations, patients, and data are safe.