Aspirin is one of those medications that people take, thinking it will help reduce their risk of heart attack or stroke. For some, it may provide some protection. However, for others, it may not reduce their risk, and may instead lead to other potentially serious medical problems.
A study that reviewed over 68,000 records showed that “more than 1 in 10 patients in this national registry were receiving inappropriate aspirin therapy for primary prevention.” This was published in the Journal of the American College of Cardiology.
Aspirin can be a useful drug as it prevents the formation of blood clots. For those who have had a heart attack or stroke, the risk of having another may be reduced by taking low-dose aspirin, HealthDay News reported.
The problem is that any benefits of taking low-dose aspirin to prevent a first heart attack or stroke, which doctors call primary prevention, are not as straightforward.
"Aspirin is not a medication that comes without risks," said Dr. Ravi Hira, the lead researcher on the study and a cardiologist at Baylor College of Medicine in Houston.
He went on to explain that aspirin can cause hemorrhagic stroke (bleeding in the brain) or serious gastrointestinal bleeding. People who have had a history of stomach ulcers have up to three times the risk of a gastric bleed than those without that history.
Hira also stated that the idea of protecting the heart by simply taking a pill might appeal to some people.
"It's probably easier to take a pill than to change your lifestyle," Hira pointed out.
The study showed that women and younger patients were more likely to be using aspirin inappropriately than men and seniors.
It was also not clear in the study whether people who had taken aspirin were doing so under the direction of their doctor. Aspirin is readily available without a prescription.
So how do you know if you should take low-dose aspirin?
First, don’t just start taking aspirin on your own. You should work with your doctor to determine if taking aspirin has a benefit that outweighs the risk.
Your doctor will review your medical history, your family history and other medications you are on, to help decide whether it is a good idea for you.
Your doctor may want you to take aspirin if you have had a previous heart attack, have a cardiac stent, or have had a stroke (secondary prevention).
If you have a strong family history along with other cardiovascular risk factors (primary prevention) he might suggest it as a good preventive practice.
Cardiovascular risk factors for both men and women include: age, diabetes, elevated cholesterol levels, high blood pressure and smoking.
In just women, atrial fibrillation and left ventricular enlargement are additional risk factors.
On the other hand, if you are already on other medications that increase the risk of bleeding, e.g., NSAIDs, Coumadin, corticosteroids or certain supplements, he may not want you to additionally take aspirin.
The U.S. Preventive Services Task Force (USPSTF) guidelines from 2012 5 state:
• Aspirin is encouraged for men ages 45-79 to reduce risk of myocardial infarction (MI) when the benefit outweighs potential harm of GI hemorrhage.
• Aspirin is encouraged for women ages 55-79 to reduce risk of ischemic stroke when the benefit outweighs the potential harm of GI hemorrhage.
The USPSTF recommends against the use of aspirin for the primary prevention of MI in men less than age 45, or stroke in women less than age 55, and men and women over the age of 80.
In general, do what you can to lower your risk of heart disease or stroke by quitting smoking if you smoke, getting regular exercise, keeping your weight down and eating a healthy diet.
Sources:
1) Too many people take aspirin to prevent heart attacks, stroke, study says. Los Angeles Times. Retrieved February 22, 2015.
http://www.latimes.com/science/sciencenow/la-sci-sn-aspirin-use-inapprop...
2) More Than 1 in 10 Use Daily Aspirin Inappropriately. (HealthDay News). Philly.com. Retrieved February 22, 2015.
http://www.philly.com/philly/health/HealthDay695397_20150112_More_Than_1...
3) Daily aspirin therapy: Understand the benefits and risks. Mayo Clinic. Retrieved February 22, 2015.
http://www.mayoclinic.org/diseases-conditions/heart-disease/in-depth/dai...
4) The Guide to Clinical Preventive Services 2012: Recommendations of the U.S. Preventive Services Task Force. Rockville (MD): Agency for Healthcare Research and Quality (US); 2012 Oct.
http://www.ncbi.nlm.nih.gov/sites/books/NBK115121/#_adults_s1_
5) Hira Ravi S. M.D. et al. Frequency and Practice-Level Variation in Inappropriate Aspirin Use for the Primary Prevention of Cardiovascular Disease. J Am Coll Cardiol. 2015;65(2):111-121. doi:10.1016/j.jacc.2014.10.035
http://content.onlinejacc.org/article.aspx?articleid=2089094
Michele is an R.N. freelance writer with a special interest in woman’s healthcare and quality of care issues.
Edited by Jody Smith