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“НАШЕ ЖИТТЯ”, ЛИПЕНЬ - СЕРПЕНЬ 2019 WWW. UNWLA .ORG 33 “TAKE TWO ASPIRINS & CALL ME IN THE MORNING” UPDATED by Ihor Magun, MD, FACP Changes in medical recommendations and advice are inevitable. As a corollar y to this, especially in response to new evidence, doctors need to alter and adjust the advice they give to patients. This month’s column addresses this phenomenon and provides updates on a few common medical sce - narios. Please note that the information pr esented is for informational purposes only and should be taken as such. All changes or recom mendation in treatments s hould be discussed with your own physician. Let’s begin with aspirin, which has been around for many years and has literally been a life- saver for many people , particularly those who have suffered a heart attack. The new recom mendations are as follows: I f you are fifty years or younger and have never had a heart attack or a stroke, you do not need to take a daily aspirin. If you have alrea dy had a heart attack, continue to take it. If you fall in between the ages of fifty and sixty - nine, log on to the web site www.cvriskcalculator.com to calculate your risk. If your risk calculates a t greater than ten percent, then aspirin should be beneficial. In the new studies related to this matter, the aspirin dose is lo w adult strength, 81 mg and can be coated or uncoated. If you are seventy or older and have never had a heart attack or stroke, there is n o con- sensus on whether aspirin is beneficial. The major concern about aspirin safety is the potential for se- rious gast rointestinal bleeding. Th e pros and cons should be discussed with your physician. Our next stop is t he American Cancer Soci- ety , which rec ommend s that colon cancer screen- ing (colonoscopy) start at the age of 45. This is five years sooner than the previous recommendation for age of screening. The reason for the adjustment to this recommendation is that the incidence of co- lon cancer in younger people is increasing d espite documented fact that colon cancer affects most people after the age of fifty . Recent stu dies and sta- tistics have shown that people seem to be getting colon cancer at a younger age. If you catch the can- cer early, it is more lik ely to be cured. The Gastro- intestinal Society has not completely endorsed this new recommendation , which may ultimatel y be- come an insurance issue. One important note is that these recom mendations do not apply to indi- viduals with colon issue s, such as a ge netic predis- position. In such cases, age is irre l e v ent and a co- lonoscopy is warranted) and a colonoscop y should be performed ten years earlier . For example, if your father (or other blood relative) had colon can- cer at the age of forty, you should have a co lonos- copy at age 30. Next we move to The American Heart As- so ciation and The American College of Cardio logy , which have released new guidelines that lower the threshold for hypertension. The goal is preserva- tion of blood vessels and reduction of cardiovas cu- lar events. The normal goal should be lower than 120/80. The guidelines are very specific and clearly state that any individual with stage 2 hyper- tension will require medication. Individuals with normal or elevated blood pressure should adhere to a heart - healthy lifestyle. The advice also strong - ly recommends home monitoring of blood pres- sure as additional readings help in blood pressure management. The home blood pressure machines are reasonably priced and are quite accurate. You can take your machine to your physician for vali- dation of your technique in taking the readings as well as the accuracy of the m achine itself . The wrist blood pressure devices are not as accurate as the upper arm types. Mammography has also been in the news and should be include d here because t he mammo - gram still remains the gold standard and The American College of Radiology reco mmends that women have screening s starting at age forty be- cause early detection saves lives. The incidence of breast cancer increases steadily with age and con- tinues until age eighty. For women with a family history of breast cancer, many additional factor s need to be taken into consideration — including the age of diagnosis of family members and breast density, which is considered a risk factor. In fact, w omen with dense breasts are estimated to have a lifetime risk of breast cancer of 20% or more. Other fac tors, like being overweight and excessive alco- hol intake , increase the risk . These issues should be discussed with your physician. In any case, screenin g is important because m ost women who develop breast cancer do not have any risk factors except being fe male and aging. Annual MRI screening in addition to mammography is recom- mended. Exercis e is known to reduce the risk. Be proactive. Heed the new resear ch , be healthy , and live well.
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