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octopocta comments on Lifestyle interventions to increase longevity - Less Wrong

121 Post author: RomeoStevens 28 February 2014 06:28AM

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Comment author: octopocta 27 February 2014 09:16:05PM 3 points [-]

I'm very surprised that there is no mention of a low-dose aspirin regime here. Low dose aspirin can greatly reduce chances of stroke, heart attack, and cancer. The main caveat is that there is increased chance of bleeding or stomach ulcer, the latter of which can be avoided by taking with food.

Comment author: RomeoStevens 27 February 2014 11:04:30PM 7 points [-]

I looked into the numbers and it's a wash for people under 45. The risks are greater than often presented, likely because the marketing is targeted at people at heightened risk who really do need to be convinced to take it.

Comment author: gwern 30 August 2015 01:50:33AM 1 point [-]

I looked into the numbers and it's a wash for people under 45.

Link? (Perhaps you didn't take into account the roughly 5 year lag before the reductions start becoming visible?) My own reading of the meta-analyses is the opposite: that while not studied very much, the cost-benefit is probably even more positive than for older people since the all-cause mortality reduction does not seem to vary by age, the benefits seem to be cumulative/have that lag (so you want to start before the cancer/death risks start going up), younger people have far more DALYs to lose, and the risk of bleeding increase substantially in the 70s and higher. No one seems to show any increase in risk or reduction in effect extrapolating from the ~50yo cutoff in most studies, and at least some people like Rothwell are raising the question of suggesting baby aspirin use for the middle-aged.

Comment author: RomeoStevens 30 August 2015 06:09:13PM 0 points [-]

My impression was that when looking at subgroups the low risk groups didn't show any significant risk reduction, and that the higher your risk profile goes the more you reduce risk[1]. So I guess a 5 year lag implies it would be reasonable to start taking it at 40. But an individual has access to better predictors than population wide analysis of age cohorts. The problem is that there is no easy way to judge the balance of risks as you age. Mortality from GI bleeding is low, but not that low[2]. I would hazard a guess that someone who gets regular blood panels and finds themselves leaving the very low risk cluster of parameters (ApoA:ApoB, CRP, high BP) it is probably on net worth it.

  1. http://www.nejm.org/doi/full/10.1056/nejm199704033361401
  2. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3309903/ (table 4)
Comment author: curiousepic 06 March 2014 08:39:51PM 1 point [-]

Is it worth it to carry around aspirin to take if you even worry you might be having a heart attack, for people under 45?

Comment author: RomeoStevens 06 March 2014 10:07:21PM 2 points [-]

carrying a small first aid kit in your day bag is pretty reasonable.

Comment author: Lumifer 06 March 2014 09:01:34PM -2 points [-]

If you worry about having a heart attack, there are better things than aspirin to carry with you.

Comment author: Vaniver 06 March 2014 09:27:28PM 4 points [-]

there are better things than aspirin to carry with you.

This post would be much more helpful if you had listed those things. The only thing I'm seeing suggested besides aspirin is nitrates of some form, which appear to be prescription.

Comment author: Lumifer 06 March 2014 09:45:14PM 0 points [-]

This post would be much more helpful if you had listed those things.

I am not a doctor and I don't want to give medical advice to unknown people over the 'net.

If curiousepic has a medical condition that causes him to have a well-founded fear of a heart attack, he really should ask his doctor -- who, among other things, will know what that condition is and can write prescriptions.

Comment author: Vaniver 06 March 2014 10:26:11PM 2 points [-]

I am not a doctor and I don't want to give medical advice to unknown people over the 'net.

Wouldn't it be better to say something like "ask your doctor, who can give you answers tailored to your medical history," then?

Comment author: Lumifer 07 March 2014 01:13:38AM -1 points [-]

No. It is a condescending answer which provides no information. My answer points out that things better than aspirin exist but leaves open the question of what would actually be appropriate for the OP. Essentially, it tells him to explore the matter further.

Comment author: Vaniver 07 March 2014 05:41:14AM *  3 points [-]

It is a condescending answer which provides no information.

Why do you think it's condescending?

My answer points out that things better than aspirin exist

But is that true? As far as I can tell, the other things that are available are recommended to people who cannot take aspirin for whatever reason, and so to call them "better" seems not quite right.

Essentially, it tells him to explore the matter further.

But saying "explore the matter further" in response to someone saying "is X worth it?" seems profoundly unhelpful, especially when you don't actually say that, compared to saying "explore the matter further by talking to your doctor" or "explore the matter further by looking into miracle drug X."