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.
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.
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.
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.
http://www.nejm.org/doi/full/10.1056/nejm199704033361401
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3309903/ (table 4)