Good health

Daily aspirin use not recommended to cut heart attack and stroke risk: Study

Jul 24, 2019

People without a risk of cardiovascular disease are no longer encouraged to take a daily dose of aspirin to cut the risk.

While millions of people globally take an aspirin daily to lower their risk of heart attack, new research from the Beth Israel Deaconess Medical Center (BIDMC) shows that the non-steroidal anti-inflammatory medication may actually do more harm than good in healthy people.

In the past, it wasn’t uncommon for health professionals to suggest daily use of low dose of aspirin – between 75 and 150mg per day – to prevent heart attacks and strokes, even for those not at risk of cardiovascular disease.

Because aspirin is a blood thinner, it can stop the blood from clotting, which is important in preventing cardiovascular disease because clots can cause blockages which can lead to heart attacks and strokes.

Several recent studies found that the medication can also cause major bleeding and that, in many cases, the benefits didn’t outweigh the risks. This led to a change in clinical practice guidelines, with the American Heart Association and American College of Cardiology now advising those over 70 without existing cardiovascular disease not to routinely use aspirin. The latest research was published in the Annals of Internal Medicine Journal.

“Although prior American Heart Association and American College of Cardiology guidelines recommended aspirin only in persons without elevated bleeding risk, the 2019 guidelines now explicitly recommend against aspirin use among those over the age of 70 who do not have existing heart disease or stroke,” senior author Christina C. Wee said in a statement.

“Our findings suggest that a substantial portion of adults may be taking aspirin without their physician’s advice and potentially without their knowledge.”

The study found aspirin use was widespread among groups most at risk of harm. This included older members of the community and adults with peptic ulcer disease – a painful condition that impacts 10 per cent of the population where sores line the stomach and are prone to bleeding. Using data from the 2017 National Health Interview Survey, researchers found a quarter of adults over 40 (29 million people) didn’t have cardiovascular disease but took aspirin daily to prevent it.

Shockingly, 6.6 million people took aspirin without guidance from a health professional, while close to half of over-70s with no history of stroke or heart attack were also using the medication.

“Our findings show a tremendous need for health care practitioners to ask their patients about ongoing aspirin use and to advise them about the importance of balancing the benefits and harms, especially among older adults and those with prior peptic ulcer disease,” lead author Colin O’Brien said in a statement,

Researchers said that the findings are for adults who use aspirin but don’t have a history of cardiovascular disease or stroke. People who are currently using aspirin should discuss it with a doctor to ensure the benefits are outweighing the risks.

It follows a 2018 published in the New England of Journal Medicine which found no health benefit of taking aspirin and those taking the medication had slightly higher rates of death. It didn’t reduce the risk of disability or cardiovascular disease and instead increased the likelihood of major bleeding problems.

In addition to causing bleeding, other common side effects of aspirin can range from dizziness, drowsiness and nausea to abdominal pain, heartburn and diarrhoea. The medication can also be used to treat mild pain, fever and swelling, but always discuss aspirin use with a doctor – even if the drug is available over-the-counter without a prescription.