Tag Archives: health

Of walking sticks, canes, scepters, and wands.

Franklin’s walking stick, willed to General Washington. Now in the Smithsonian.

Many famous people carried walking sticks Washington, Churchill, Moses, Dali. Until quite recently, it was “a thing”. Benjamin Franklin willed one, now in the Smithsonian, to George Washington, to act as a sort of scepter: “My fine crab-tree walking stick, with a gold head curiously wrought in the form of the cap of liberty, I give to my friend, and the friend of mankind, General Washington. If it were a Scepter, he has merited it, and would become it. It was a present to me from that excellent woman, Madame de Forbach, the dowager Duchess of Deux-Ponts”. A peculiarity of this particular stick is that the stick is uncommonly tall, 46 1/2″. This is too tall for casual, walking use, and it’s too fancy to use as a hiking stick. Franklin himself, used a more-normal size walking stick, 36 3/8″ tall, currently in the collection of the NY Historical Society. Washington too seems to have favored a stick of more normal length.

Washington with walking stick

Walking sticks project a sort of elegance, as well as providing personal protection. Shown below is President Andrew Jackson defending himself against an assassin using his walking stick to beat off an assassin. He went on to give souvenir walking sticks to friends and political supporters. Sticks remained a common political gift for 100 years, at least through the election of Calvin Coolidge.

Andrew Jackson defends himself.

I started making walking sticks a few years back, originally for my own use, and then for others when I noticed that many folks who needed canes didn’t carry them. It was vanity, as best I could tell: the normal, “old age” cane is relatively short, about 32″. Walking with it makes you bend over; you look old and decrepit. Some of the folks who needed canes, carried hiking sticks, I noticed, about 48″. These are too tall to provide any significant support, as the only way to grasp one was from the side. Some of my canes are shown below. They are about 36″ tall, typically with a 2″ wooden ball as a head. They look good, you stand straight, and they provides support and balance when going down stairs.

Some of my walking sticks.

I typically make my sticks of American Beech, a wood of light weight, with good strength, and a high elastic modulus of elasticity, about 1.85 x106 psi. Oak, hickory, and ash are good options, but they are denser, and thus more suited to self-defense. Wood is better than metal for many applications, IMHO, as I’ve discussed elsewhere. The mathematician Euler showed the the effective strength of a walking stick does not depend on the compressive strength but rather on elastic constant via “the Euler buckling equation”, one of many tremendously useful equations developed by Leonhard Euler (1707-1783).

For a cylindrical stick, the maximum force supported by a stick is: F = π3Er4/4L2, where F is the force, r is the radius, L is the length, and E is the elastic modulus. I typically pick a diameter of 3/4″ or 7/8″, and fit the length to the customer. For a 36″ beech stick, the buckling strength is calculated to be 221 or 409 pounds respectively. I add a rubber bottom to make it non–scuff and less slip-prone. I sometimes add a rope thong, too. Here is a video of Fred Astaire dancing with this style of stick. It’s called “a pin stick”, in case you are interested because it looks like a giant pin.

Country Irishmen are sometimes depicted with a heavy walking stick called a Shillelagh. It’s used for heavier self-defense than available with a pin-stick, and is generally seen being used as a cudgel. There are Japanese versions of self defense using a lighter, 36″ stick, called a Han-bo, as shown here. There is also the wand, as seen for example in Harry Potter. It focuses magical power. Similar to this is Moses’s staff that he used in front of Pharaoh, a combination wand and hiking stick as it’s typically pictured. It might have been repurposed for the snake-on-a-stick that protects against dark forces. Dancing with a stick, Astaire style, can drive away emotional forces, while the more normal use is elegance, and avoiding slips.

Robert Buxbaum, April 20, 2023.

Almost no one over 50 has normal blood pressure now.

Four years ago, when the average lifespan of American men was 3.1 years longer than today, the American Heart Association and the American College of Cardiology dropped the standard for normal- acceptable blood pressure for 50+ years olds from 140/90 to 120/80. The new standard of normal was for everyone regardless or age or gender despite the fact that virtually no one over 50 now reached it. Normal is now quite un-common.

By the new definition, virtually everyone over 50 now is diagnosed with high blood pressure or hypertension. Almost all require one or two medications — no more baby aspirin. Though the evidence for aspirin’s benefit is strong, it doesn’t lower blood pressure. AHA guidance is to lower a patients blood pressure to <140/90 mmHg or at least treat him/her with 2–3 antihypertensive medications.4 

Average systolic blood pressures for long-lived populations of men and women without drugs.

The graphs shows the average blood pressures, without drugs in a 2008 study of the longest-lived, Scandinavian populations. These were the source of the previous targets: the natural pressures for the healthiest populations at the time, based on the study of 1304 men (50-79 years old) and 1246 women (38-79 years old) observed for up to 12 years. In this healthy population, the average untreated systolic pressure is seen till age 70, reaching 154 for men, and over 160 for women. By the new standards, these individuals would be considered highly unhealthy, though they live a lot longer than we do. The most common blood-pressure drug prescribed in the US today is atenolol, a beta blocker. See my essay on Atenolol. It’s good at lowering blood pressure, but does not decrease mortality.

The plot at left shows the relationship between systolic blood pressure and death. There is a relationship, but it is not clear that the one is the cause of the other, especially for individuals with systolic pressure below 160. Those with pressures of 170 and above have significantly higher mortality, and perhaps should take atenolol, but even here it might be that high cholesterol, or something else, is causing both the high blood pressure and the elevated death risk.

The death-risk difference between 160 and 100 mmHg is small and likely insignificant. The minimum at 110 is rather suspect too. I suspect it’s an artifact of a plot that ignores age. Only young people have this low number, and young people have fewer heart attacks. Artificially lowering a person’s blood pressure, even to this level does not make him young, [2][3] and brings some problems. Among the older-old, 85 and above, a systolic blood pressure of 180 mmHg is associated with resilience to physical and cognitive decline, though it is also associated with higher death rate.

The AHA used a smoothed version of the life risk graph above to justify their new standards, see below. In this version, any blood pressure looks like it’s bad. The ideal systolic pressure seems to be 100 or below. This is vastly too low a target, especially for a 60 year old. Based on the original graph, I would think that anything below 155 is OK.

smoothed chart of deaths per 1000 vs blood pressure. According to this chart, any blood pressure is bad. There is no optimum.

Light exercise seems to do some good especially for the overweight. Walking helps, as does biking, and aerobics. Weight loss without exercise seems to hurt health. Aspirin is known to do some good, with minimal cost and side effects. Ablation seems to help for those with atrial fibrillation. Elequis (a common blood thinner) seems to have value too, for those with atrial fibrillation — not necessarily for those without. Low sodium helps some, and coffee, reducing gout, dementia and Parkinson’s, and alcohol. Some 2-3 drinks per day (red wine?) is found to improve heart health.

I suspect that the Scandinavians live longer because they drink mildly, exercise mildly, have good healthcare (but not too good), and have a low crime rate. They seem to have dodged the COVID problem too, even Sweden that did next to nothing. it’s postulated that the problem is over medication, including heart medication.

Robert Buxbaum, January 4, 2023. The low US lifespan is startling. Despite spending more than any other developed countries on heath treatments, we have horribly lower lifespans, and it’s falling fast. A black man in the US has the same expected lifespan as in Rwanda. Causes include heart attacks and strokes, accidents, suicide, drugs, and disease. Opioids too, especially since the COVID lockdowns.

Coffee decreases your chance of Parkinson’s, a lot.

Some years ago, I thought to help my daughter understand statistics by reanalyzing the data from a 2004 study on coffee and Parkinson’s disease mortality, “Coffee consumption, gender, and Parkinson’s disease mortality in the cancer prevention study II cohort: the modifying effects of estrogen” , Am J Epidemiol. 2004 Nov 15;160(10):977-84, see it here

For the study, a cohort of over 1 million people was enrolled in 1982 and assessed for diet, smoking, alcohol, etc. Causes of deaths were ascertained through death certificates from January 1, 1989, through 1998. Death certificate data suggested that coffee decreased Parkinson’s mortality in men but not in women after adjustment for age, smoking, and alcohol intake. They used a technique I didn’t like though, ANOVA, analysis of variance. That is they compare the outcome of those who drank a lot of coffee (4 cups or more) to those who drank nothing. Though women in the coffee cohort had about 49% the death rate, it was not statistically significant by the ANOVA measure (p = 0.6). The authors of the study understood estrogen to be the reason for the difference.

Based on R2, coffee appears to significantly decrease the risk of Parkinson’s mortality in both men and women.

I thought we could do a better by graphical analysis, see plot at right, especially using R2 to analyze the trend. According to this plot it appears that coffee significantly reduces the likelihood of death in both men and women, confidence better than 90%. Women don’t tend to drink as much coffee as men, but the relative effect per cup is stronger than in men, it appears, and the trend line is clearer too. In the ANOVA, it appears that the effect in women is small because women are less prone Parkinson’s.

The benefit of coffee has been seen as well, in this study, looking at extreme drinkers. Benefits appear for other brain problems too, like Alzheimer’s. It seems that 2-4 cups of coffee per day also reduces the tendency for suicide, and decreases the rate of gout. It seems to be a preventative against kidney stones, too.

There is a confounding behavior that I should note, it’s possible that people who begin to feel signs of Parkinson’s, etc. stop drinking coffee. I doubt it, give the study’s design, but it’s worth a mention. The same confounding is also present in a previous analysis I did that suggested that being overweight protected from dementia, and from Alzheimer’s. Maybe pre-dementia people start loosing weight long before other symptoms appear.

Dr. Robert E. Buxbaum, and C.M. Buxbaum, December 15, 2022

Eliquis, over-prescribed but better than Coumadin.

Eliquis (apixaban) is blood thinner shown to prevent stroke with fewer side effects than Warfarin (Coumadin). Aspirin does the same, but not as effectively for people over 75. My problem with eliquis is that it’s over-prescribed. The studies favoring it over aspirin found benefits for those over 75, and for those with A-Fib. And even in this cohort the advantage over aspirin is small or non-existent because eliquis has far more serious side effects; hemorrhage, or internal bleeding.

Statistically, the AVERROES study (Apixaban Versus Acetylsalicylic Acid to Prevent Stroke in AF Patients Who Have Failed or Are Unsuitable for Vitamin K Antagonist Treatment) found that apixaban is substantially better than aspirin at preventing stroke in atrial fibrillation patients, but worse at preventing heart attack.

Taking 50 mg of Eliquis twice a day, reduces the risk of stroke in people with A-Fib by more than 50% and reduces the rate of heart attack by about 15%. By comparison, taking 1/2 tablet of aspirin, 178 mg, reduces the risk of stroke by 17% and of heart attack by 42%. The benefits were higher in the elderly, those over 75, and non existent in those with A-Fib under 75, see here, and figure. Despite this, doctors prescribe Eliquis over aspirin, even to those without A-Fib and those under 75. I suspect the reason is advertising by the drug companies, as I’ve claimed earlier with Atenolol.

The major deadly side-effect is hemorrhage, brain hemorrhage and GI (stomach) hemorrhage. Here apixaban is far worse than with aspirin (but better than Warfarin). The net result is that in the AVERROES random-double blind study there was no difference in all-cause mortality between apixaban and aspirin for those with A-fib who were under 75, see here. Or here.

To reduce your chance of GI hemorrhage with Eliquis, it is a very good idea to take a stomach proton pump drug like Pantoprazole. If you have A-Fib, the combination of Eliquis and pantoprazole seems better than aspirin alone, even for those under 75. If you have no A-Fib and are under 75, I see no benefit to Eliquis, especially if you find you have headaches, stomach aches, back pain, or other signs of internal bleeding, you might switch to aspirin or choose a reduced dose.

A Japanese study found that half the normal dose of Eliquis, was approximately as effective as the full dose, 50 mg twice a day. I was prescribed Eliquis, full dose twice a day, but I’m under 70 and I have no A-Fib since my ablation.

Life expectancy has dropped in the US to undeveloped world levels. Biden blames COVID and racism. I think it’s too much drugs, and too few opportunities.

I’m struck by the fact that US life expectancy is uncommonly low, lower than in most developed countries. Lower too than in many semi-developed countries, and our life expectancy is decreasing while other countries are not seeing the same. It dropped by about 3 years over the last 2 years as shown. I wonder why the US has suffered more than other countries, and suspect we are over-prescribed. Too much of a good thing, typically isn’t good.

Robert Buxbaum, September 16, 2022. As a side issue, low dose aspirin may forestall Alzheimers and other dementias. See current article here. Also another study here.

Curing my heart fibrillation with ablation.

Two years ago, I was diagnosed with Atrial fibrillation, A-Fib in common parlance, a condition where my heart would sometimes speed up to double its normal speed. I was prescribed metopolol and then atenolol, common beta blockers, and a C-Pap for sleep apnea. None of this seemed to help, as best I could tell from occasional pulse measurements with watch and a finger pulse-oxometer. Besides, the C-Pap was giving me cough and the beta blockers made me dizzy. And the literature on C-Pap did not impress.

So, some moths ago, I bought an iWatch. The current versions allows you to take EKGs and provides a continuous record of your heart rate. This was very helpful, as I saw that my heart rate was transitioning to chaos. While it was normally predictable, it would zoom to 130 or so at some point virtually every day. Even more alarming, it would slow down to the mid 30s at some point during the night, bradycardia, and I could see it was getting worse. At that point, I agreed to go on eliquis, a blood thinner, and agreed to a catheter ablation. The doctor put a catheter into my heart by way of a leg vein, and zapped various nerve centers in the heart. The result is that my heart is back into normal behavior. See the heart-rate readout from my iWatch below; before and after are dramatically different.

My heart rate for the last month, very variable before the ablation treatment, 2 weeks ago; a far less variable range of heart rates in the two weeks following the treatment. Heart rate data is from my iPhone and iwatch — a good investment, IMHO.

The reason I chose ablation over drugs or no therapy was that I read health-studies on line. I’ve go a PhD, and that training helps me to understand the papers I’ve read, but you should read them too. They are not that hard to understand. Though ablation didn’t appear as a panacea, it was clearly better than the alternatives. Particularly relevant was the CABANA study on life expectancy. CABANA stands for “Catheter ABlation vs ANtiarrhythmic Drug Therapy for Atrial Fibrillation – CABANA”. https://www.acc.org/latest-in-cardiology/clinical-trials/2018/05/10/15/57/cabana.

2,204 individuals with persistent AF were followed for 5 years after treatment, 37% female, 63% male, average age 67.5. Prior hospitalization for AF: 39%. The results were as follows:

  • Death: 5.2% for ablation vs. 6.1% for drug therapy (p = 0.38)
  • Serious stroke: 0.3% for ablation vs. 0.6% for drug therapy (p = 0.19)
  • All-cause mortality: 4.4% for ablation vs. 7.5% for drug therapy (p = 0.005)
  • Death or CV hospitalization: 51.7% for ablation vs. 58.1% for drug therapy (p = 0.002)
  • Pericardial effusion with ablation: 3.0%; ablation-related events: 1.8%
  • First recurrent AF/atrial flutter/atrial tachycardia: 53.8% vs. 71.9% (p < 0.0001)

I found all of this significant, including the fact that 27.5% of those on the drug treatment crossed over to have ablation while only 9.2% on the ablation side crossed to have the drug treatment.

I must give a plug for doctor Ahmed at Beaumont Hospital who did the ablation. He does about 200 of these a year, and does them well. Do not go to an amateur. I was less-than impressed with him pushing the beta-blocker hard; I’ll write about that. Also, get an iWatch if you think you may have A-Fib or any other heart problem. You see a lot, just by watching, so to speak.

Robert Buxbaum, August 3, 2022.

Hypochondriacs anonymous: the first step is admitting you don’t have a disease.

I’m writing a book about reverse psychology; please don’t buy it.

This one’s not by Rappaport

The judge said I had to keep 6 feet away from my ex-wife. So I buried her under the patio.

Robert Buxbaum: the above 3 jokes are from Jack Rappaport — He sometimes sells jokes. April 13, 2022. The ones below are from Gahan Wilson, and the one at right, I don’t know.

These last two are from Gahan Wilson

C-PAPs do not help A-Fib, and seem to make heart health worse.

In this blog-post, I’d like to report on the first random study of patients with Atrial fabulation, A-Fib, and sleep apnea, comparing the health outcome of those who use a C-PAP, a “Continuous Positive Airway Pressure” device, to the outcome those who do not. The original study was published in May, 2021 (read it here) in the American Journal of Respiratory and Critical Care Medicine. The American Journal, Pulmonary Advisor published a more-popular version here.

As a background, if you are over 65 and overweight, there is a 25% chance or so that your heart rate will begin to surge semi-randomly, and that it will flutter. This is Atrial fabulation, A-Fib. It tends to get worse and tends to lead to heart attacks and strokes. People with A-fib tend to be treated with drugs, aspirin, warfarin, beta blockers, and anti arrhythmics. They also tend to be prescribed a C-PAP because overweight, older folks tend to snore and wake up a lot during the night (several times per hour: apnea).

A C-PAP definitely stops the snoring and the Apnea, and the assumption was that it would help your heart as well, if only by giving you a better night’s sleep. As it turns out, the C-PAP seems to decrease heart health — significantly.

For this study, adult patients between 18 and 75 years old diagnosed with paroxysmal A-Fib (that’s occasional AF) were screened for moderate to severe sleep apnea. Those who agreed to participate were randomly assigned to either a treatment of C-PAP plus usual care (drugs mostly) or just usual care for the next 5 months. Of the 109 who enrolled in the study, 55 got the C-PAP plus usual care, 54 got usual care alone. The outcome was that there were 9 serious, adverse heart events (strokes and heart attacks); 7 were in the C-PAP group.

The CPAP pressure was, on average, 6.8 cm H2O; mean time of use was 4.4±1.9 hours per night. The C-PAPs did their jobs on the apnea too, reducing residual apnea-hypopnea to 2.3±1.9 events per hour for those in the C-PAP group.

There was a non-statistically significant reduction is AF among the C-PAP group. They reduced their time in AF by 0.6 percentage points compared to the control group  (95% CI, -2.55 to 1.30; P =.52). That not a statistically significant difference, and is most likely random.

There was a statistically significant decrease in heart health, though. A total of 7 serious adverse events occurred in the C-PAP group and only 2 in the control group. A total of 9 is a relatively small number of events, but there is a strong statistical difference between 7 and 2.

The authors conclude: “CPAP treatment does not seem to reduce or prevent paroxysmal AF.” They should also have concluded that it reduced heart health with a statistical confidence of ~82%: (1-2(36+10)/512) =82%. See more on this type of statistics.

A possible explanation of why a C-PAP would would make heart health worse is an outcome of the this recent sleep study (link here). It appears that the C-PAP helps restore breathing, but by doing so, it interferes with a mechanism the body uses to deal with A-fib. It seems that, for people with A-Fib, their bodies use breathing stoppages to get their heart back into rhythm. For these people, many of their breathing stoppage are not obstructive, but a bio-pathway to raise the CO2 level in the blood and thus regulate heart rate. The use of a C-PAP prevents this restorative mechanism and this seem to be the reason it is destructive to the heart-health of patients with A-fib. On the other hand, a C-PAP does improve the sleep those patients whose apnea is obstructive. It seems to me that sleep studies should do a better job distinguishing the two causes of apnea. C-PAPs seem counter-indicated for patients with A-fib.

Robert Buxbaum, March 30, 2022. I was diagnosed with apnea and A-Fib some years ago. The sleep doctor prescribed a C-PAP and was adamant that I had to use it to keep my heart healthy. There were no random studies backing him up or contradicting him until now.

Exercise helps fight depression, lithium helps too.

With the sun setting earlier, and the threat of new COVID lockdowns, there is a real threat of a depression, seasonal and isolation. A partial remedy is exercise; it helps fight depression whether you take other measures not. An article published last month in the Journal of Affective Disorders reviewed 22 studies of the efficacy of exercise, particularly as an add-on to drugs and therapy. Almost every study showed that exercise helped, and in some studies it helped a lot. See table below. All of the authors are from the University of British Columbia. You can read the article here.

From “Efficacy of exercise combined with standard treatment for depression compared to standard treatment alone: A systematic review and meta-analysis of randomized controlled trials.” by JacquelineLee1 et al.In virtually every study, exercise helps fight depression.

For those who are willing to exercise, there are benefits aside from mental health. Even a daily walk around the block helps with bone strength, weight control, heart disease, plus the above mentioned improvement in mood. More exercise does more. If you bicycle without a helmet, you’re likely to live longer than if you drive.

For those who can’t stand exercise, or if exercise isn’t quite enough to send away the blues, you can try therapy, medication, and/or diet. There is some evidence that food that are high in lithium help fight depression. These food include nuts, beans, tomatoes, some mineral waters, e.g. from Lithia springs, GA. The does is about 1/100 the dose given as a bipolar treatment, but there is evidence that even such small doses help. Lithium was one of the seven ingredients in seven up — it was the one that was supposed to cheer you up. See some research here.

Robert Buxbaum, October 7, 2021.

is a colder world better.

For the last several years it has been claimed that some 98% of legitimate scientists believe it is a major need to reduce CO2 output so as to stop the world from getting warmer. When Trump visited the pope 4 yers ago, the pope would not speak to him expect to hand him his anti-global warming letter he’d written, “Laudato Si” and to tell Trump to get on board to stop global warming. Trump said he would read the letter.

Trump visits the pope, and the pope does not look happy

I’m not a fan of science established by Papal dictate based on an informal poll of experts, especially here where the minority includes some of the greatest minds of the 20th century, and the poll is taken by Al Gore’s science expert, but that’s where we are when it comes to science and politics. I also find it that the pope blames the US for global warming but not China when the the majority of CO2 came from China, a country committed to increasing its use of coal. But be this as it may be — the pope doesn’t blame China for imprisoning Catholics either, most recently the editor of Hong Kong’s most widely read newspaper.

So I thought I take a step back to look at the desirability of making the world colder. Is a colder world a better world? Sad pictures of polar bears are presented in favor of the colder world, but for all I know, polar bears prefer it warm. Their numbers are increasing.

Paul McCarthy lyrics; Hey Jude.

If we had a global climate adjustment knob somewhere, a magic knob allowing you to make the world warmer or colder by turning it right, or left, I doubt the consensus would be to turn the knob left. There is no real logic to cold being good, but there is a line in “Hey Jude”: “…It’s a fool who plays it cool, by making his world a little colder.” And Svente Arrhenius, one of the great scientists of 100 years ago, said he preferred a warm earth to a cold one to avoid disease and starvation. When the climate turns colder, the result is disease and famine as crops fail and animals freeze. It’s not an option that I’d think most people would prefer. given my choice, I would prefer things a little warmer.

I should also note that our ability to fine tune the climate is not what we’d think. The world climate is chaotic, and there is no reliable knob. Historically, the most common setting is ice-age, and that’s a setting that most people really don’t like.

Robert Buxbaum, February 20, 2021.

Aspirin protection from heart attack and COVID-19 death.

Most people know that aspirin can reduce blood clots and thus the risk heart attack, as shown famously in the 1989 “Physicians’ Health Study” where 22,000 male physicians were randomly assigned to either a regular aspirin (325 mg) every other day or an identical looking placebo. The results are shown in the table below, where “Myocardial Infarction” or “MI” is doctor-speak for heart attack.

TreatmentMyocardial InfarctionsNo InfarctionTotalfraction with MI
Aspirin13910,89811,037139/11,037 = 0.0126
Placebo23910,79511,034239/11,034 = 0.0217

Over the 5 years of the study, the physicians had 378 MI events, but mostly in the group that didn’t take aspirin: 1.28% of the doctors who took aspirin had a heart attack as opposed to 2.17% for those with the placebo. The ratio 1.28/2.17 = 0.58 is called the risk ratio. Apparently, aspirin in this dose reduces your MI risk to 58% of what it was otherwise — at least in white males of a certain age.

A blood clot showing red cells held together by fibrin fibers. Clots can cause heart attack, stroke, and breathing problems. photo: Steve Gschmeissner.

Further study showed aspirin benefits with women and other ethnicities, and benefits beyond hear attack, in any disease that induces disseminated intravascular coagulopathy. That’s doctor speak for excessive blood clots. Aspirin produced a reduction in stroke and in some cancers (Leukemia among them) and now it now seems likely that aspirin reduces the deadliness of COVID-19. Data from Wuhan showed that excessive blood clots were present in 71% of deaths vs. 0.4% of survivors. In the US, some 30% of those with serious COVID symptoms and death show excessive blood clots, particularly in the lungs. Aspirin and Vitamin D seem to help.

.The down-side of aspirin use is a reduction in wound healing and some intestinal bleeding. The intestinal bleeding is known as aspirin burn. Because of these side-effects it is common to give a lower dose today, just one baby aspirin per day, 81 mg. While this does does some good, It is not clear that it is ideal for all people. This recent study in the Lanset (2018) shows a strong relationship between body weight and aspirin response. Based on 117,279 patients, male and female, the Lanset study found that the low dose, baby aspirin provides MI benefits only in thin people, those who weigh less than about 60 kg (130 lb). If you weigh more than that, you need a higher dose, perhaps two baby aspirin per day, or a single adult aspirin every other day, the dose of the original doctors study.

In this study of COVID patients, published in July, those who had been taking aspirin fared far better than those who did not A followup study will examine the benefits of one baby aspirin (81 mg) with and without Vitamin D, read about it here. I should note that other pain medications do not have this blood-thinning effect, and would not be expected to have the same benefit.

While it seems likely that 2 baby aspirins might be better in fat people, or one full aspirin every other day, taking a lot more than this is deadly. During the Spanish flu some patients were given as much as 80 adult aspirins per day. It likely killed them. As Paracelsus noted, the difference between a cure and a poison is the dose.

Robert Buxbaum, November 27, 2020.