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Aspirin intake to prevent heart attacks and strokes is not always sensible

Aspirin intake to prevent heart attacks and strokes is not always sensible


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Health benefits of aspirin are under scrutiny

Headache and fever are known to be treated with aspirin, but the pain medication is also used to prevent heart attacks and strokes. Now an American research team has found that taking aspirin daily to prevent such diseases is no longer recommended for everyone.

Aspirin prevents the formation of blood clots, which are the main cause of heart attacks and strokes. Therefore, the drug is also partially recommended for the prevention of heart disease. But new research from the United States concludes that taking aspirin daily to prevent heart attack or stroke should no longer be recommended for people who have not yet had any of these conditions.

Risks are too high

Previous scientific studies had shown that taking aspirin is unsuitable for many people to prevent cardiovascular diseases.

A few months ago, researchers at the Beth Israel Deaconess Medical Center reported that the risks of possible side effects when taking aspirin to prevent heart disease are too high for many people to justify the daily intake. The results of their study were published in the English-language journal "Annals of Internal Medicine".

A recent study by a research team from the University of Georgia (UGA) is now coming to similar conclusions.

Prevention with aspirin only if there is an increased cardiovascular risk

According to a UGA statement, nearly a quarter of Americans over 40 said they took aspirin daily, even if they had no heart disease or stroke in the past. That's a problem, said study author Mark Ebell, a researcher at the University of Georgia.

As a doctor and epidemiologist at the UGA College of Public Health, Ebell evaluates the evidence that underpins clinical practice and health behavior. The current recommendation for aspirin as the primary form of heart attack or stroke prevention is limited to adults aged 50 to 69 with an increased cardiovascular risk.

"We shouldn't just assume that everyone benefits from low-dose aspirin," said Ebell. According to the expert, the data shows "the potential benefit equals the potential harm to most people who have not had a cardiovascular event and are taking it to prevent an initial heart attack or stroke."

More harm than good

It was first discovered 30 years ago that aspirin lowers the risk of fatal and non-fatal heart attacks. Later studies have shown that the drug also reduces the risk of stroke and colon cancer.

But the consumption of aspirin has always brought risks, said Ebell, among other things for internal bleeding in the stomach and brain.

Recent studies suggest that taking aspirin does more harm than good.

"When you look back to the 1970s and 1980s when many of these original studies were being conducted, patients were not taking statins to control cholesterol, their blood pressure was not well controlled, and they were not being tested for colorectal cancer," said Ebell.

High number of hemorrhages

Ebell and his colleague Frank Moriarty from the Royal College of Surgeons in Ireland compared aspirin studies with patient data from 1978 to 2002 with four large-scale aspirin studies conducted after 2005 when statin use and colon cancer screening were more common.

They found that 1,000 patients treated for five years experienced four fewer cardiovascular events and seven major bleeding events. Ebell was particularly concerned about the number of cerebral haemorrhages experienced by aspirin users.

“About 1 in 300 people who took aspirin for 5 years suffered a brain haemorrhage. It's pretty bad. This type of bleeding can be fatal, ”he said. The study results
were published in the family practice magazine.

Discuss prevention options with the doctor

Ebell urges people who are concerned about their cardiovascular risk but have not had a heart attack or stroke to talk to their doctors about other ways to prevent a major cardiovascular event.

The treatment of high blood pressure and cholesterol as well as diabetes is more aggressive these days and the rate of other risk factors such as smoking has decreased.

"There are so many things we are now doing better to reduce the risk of cardiovascular disease and colorectal cancer so that aspirin is used less," the expert concluded. (ad)

Author and source information

This text corresponds to the specifications of the medical literature, medical guidelines and current studies and has been checked by medical doctors.

Swell:

  • University of Georgia: Aspirin’s health benefits under scrutiny, (accessed: December 11, 2019), University of Georgia
  • Family Practice: A comparison of contemporary versus older studies of aspirin for primary prevention, (accessed: December 11, 2019), Family Practice
  • Annals of Internal Medicine: Prevalence of Aspirin Use for Primary Prevention of Cardiovascular Disease in the United States: Results From the 2017 National Health Interview Survey, (accessed: December 11, 2019), Annals of Internal Medicine


Video: Aspirin: The Latest Thinking (October 2022).