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Heart disease and stroke are the leading causes of death in the United States, accounting for more than one in four deaths. While daily aspirin use has been shown to lower the chance of having a first heart attack or stroke, it can also increase the risk for bleeding in the brain, stomach and intestines. Although the absolute risk of a bleeding event is low, the risk increases with age.
“Based on current evidence, the task force recommends against people 60 and older starting to take aspirin to prevent a first heart attack or stroke,” task force vice chair Dr. Michael Barry, professor of Medicine at Massachusetts General Hospital, told ABC News. “Because the chance of internal bleeding increases with age, the potential harms of aspirin use cancel out the benefits in this age group.”
“People who are 40 to 59 years old and dont have a history of cardiovascular disease but are at higher risk may benefit from starting to take aspirin to prevent a first heart attack or stroke,” task force member Dr. John Wong, interim Chief Scientific Officer and Professor of Medicine at Tufts Medical Center, told ABC News. “Its important that they decide together with their healthcare professional if starting aspirin is right for them because daily aspirin does come with possible serious harms.”
New Guidelines Don’t Recommend Aspirin For Heart Disease Prevention
– The US Preventive Services Task Force says people over the age of 60 should not take low-dose aspirin for prevention of cardiovascular disease.
The new guidelines released Tuesday also say people 40 to 59 years old should make their own decision on taking aspirin. The task force says the benefit is small for this age group.
We spoke with Dr. Amit Khera, Cardiologist for the UT Southwestern Medical Center, about the new guidelines.
Dr. Khera: If you already have had a heart attack and stroke, these guidelines do not pertain to you. Largely, it’s a good thing to review the new evidence every few years, the last USPSTF guideline was 2016. So a lot has happened and mainly some new studies came out that really helped us understand that balance of risk and benefit with aspirin. It was time to sort of relook at that.
What do we make of this?
Dr. Khera: That’s what these guidelines do, they give us specific parameters. Essentially what they say is if you are 40 to 59 years old, and if your risk of having a heart attack or stroke is a little bit higher, so here they use 10% risk in the next 10 years or higher. If you don’t have a lot of bleeding issues, then aspirin may be right for you. I think the key point here is that rather than using aspirin routinely, which people did in the past, we need to be more selective and have a conversation with your provider to determine if that’s appropriate for you.
Preventing Heart Disease Requires More Than Medicine
The stakes are high: Heart disease is the leading cause of death in the United States, and is the cause of more than 1 in 4 deaths killing more Americans than cancer, Covid-19, and Alzheimer disease in 2021. More than 1 million Americans have their first heart attack or stroke each year, statistics from the American Heart Association show.
Black people are more likely to develop cardiovascular disease than non-Black people, although the report notes race is a social construct and an imperfect proxy for social determinants of health and the effects of structural racism, so some calculations of risk may be inaccurate. Sex is another risk factor. Those assigned male at birth bear the brunt of cardiovascular disease and its effects on quality of life, but those assigned female at birth are more likely to die from cardiovascular issues, including stroke, which they experience later in life than men.
The task forces analysis found that the benefits of aspirin for preventing cardiovascular disease is about the same for doses from 50 milligrams to 500 milligrams. The dose recommended by the USPSTF is 81 milligrams, the most commonly prescribed amount in the United States. The task force continued to support its position that there is little evidence that low-dose aspirin prevents colorectal cancer, and that as with cardiovascular disease the harms may outweigh the benefits.
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Aspirin Is Linked With Increased Risk Of Heart Failure
Sophia Antipolis, 23 November 2021: Aspirin use is associated with a 26% raised risk of heart failure in people with at least one predisposing factor for the condition. Thats the finding of a study published today in ESC Heart Failure, a journal of the European Society of Cardiology .1 Predisposing factors included smoking, obesity, high blood pressure, high cholesterol, diabetes, and cardiovascular disease.
This is the first study to report that among individuals with a least one risk factor for heart failure, those taking aspirin were more likely to subsequently develop the condition than those not using the medication, said study author Dr. Blerim Mujaj of the University of Freiburg, Germany. While the findings require confirmation, they do indicate that the potential link between aspirin and heart failure needs to be clarified.
The influence of aspirin on heart failure is controversial. This study aimed to evaluate its relationship with heart failure incidence in people with and without heart disease and assess whether using the drug is related to a new heart failure diagnosis in those at risk.
The average age of participants was 67 years and 34% were women. At baseline, a total of 7,698 participants were taking aspirin. During the 5.3-year follow-up, 1,330 participants developed heart failure.
Most Adults Shouldn’t Take Daily Aspirin To Prevent Heart Attack Us Panel Says
Older adults without heart disease shouldn’t take daily low-dose aspirin to prevent a first heart attack or stroke, an influential health guidelines group said in preliminary updated advice released Tuesday.
Bleeding risks for adults in their 60s and up who haven’t had a heart attack or stroke outweigh any potential benefits from aspirin, the U.S. Preventive Services Task Force said in its draft guidance.
For the first time, the panel said there may be a small benefit for adults in their 40s who have no bleeding risks. For those in their 50s, the panel softened advice and said evidence of benefit is less clear.
The recommendations are meant for people with high blood pressure, high cholesterol, obesity or other conditions that increase their chances for a heart attack or stroke. Regardless of age, adults should talk with their doctors about stopping or starting aspirin to make sure it’s the right choice for them, said task force member Dr. John Wong, a primary-care expert at Tufts Medical Center.
“Aspirin use can cause serious harms, and risk increases with age,” he said.
If finalized, the advice for older adults would backtrack on recommendations the panel issued in 2016 for helping prevent a first heart attack and stroke, but it would be in line with more recent guidelines from other medical groups.
Doctors have long recommended daily low-dose aspirin for many patients who already have had a heart attack or stroke. The task force guidance does not change that advice.
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Aspirin Linked With Increased Risk Of Heart Failure In New Study
Aspirin use is associated with a 26% raised risk of heart failure in people with at least one predisposing factor for the condition. Thats the finding of a study published today in ESC Heart Failure, a journal of the European Society of Cardiology . Predisposing factors included smoking, obesity, high blood pressure, high cholesterol, diabetes, and cardiovascular disease.
This is the first study to report that among individuals with a least one risk factor for heart failure, those taking aspirin were more likely to subsequently develop the condition than those not using the medication, said study author Dr. Blerim Mujaj of the University of Freiburg, Germany. While the findings require confirmation, they do indicate that the potential link between aspirin and heart failure needs to be clarified.
The influence of aspirin on heart failure is controversial. This study aimed to evaluate its relationship with heart failure incidence in people with and without heart disease and assess whether using the drug is related to a new heart failure diagnosis in those at risk.
The average age of participants was 67 years and 34% were women. At baseline, a total of 7,698 participants were taking aspirin. During the 5.3-year follow-up, 1,330 participants developed heart failure.
How Does Aspirin Help Prevent Heart Attack And Stroke
Most heart attacks and strokes occur when the blood supply to a part of your heart muscle or brain is blocked. This usually starts with atherosclerosis, a process in which deposits of fatty substances, cholesterol, cellular waste products, calcium and other substances build up in the inner lining of an artery. This buildup is called plaque.
Plaque usually affects large and medium-sized arteries. Plaques can grow large enough to significantly reduce the blood’s flow through an artery. But most of the damage occurs when a plaque becomes fragile and ruptures. Plaques that rupture cause blood clots to form that can block blood flow or break off and travel to another part of the body. This is called an embolism.
- If a blood clot blocks a blood vessel that feeds the heart, it causes a heart attack.
- If a blood clot blocks a blood vessel that feeds the brain, it causes a stroke.
Aspirin thins the blood, which helps prevent blood clots from forming.
Certain patients will be prescribed aspirin combined with another antiplatelet drug also known as dual antiplatelet therapy . Learn more about DAPT.
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Evidence Shows The Modest Benefits Of Aspirin In Preventing Heart Disease Often Dont Outweigh Risks
The panels proposed recommendations are in line with existing evidence, said Jim Liu, MD, a cardiologist at The Ohio State University. Previous studies through the years have suggested that aspirin offers only a very modest benefit, if any at all, in preventing cardiovascular disease, he said.
In the past three years, there have been a couple of large randomized trials once again studying aspirin for preventative purposes. These newer studies have all found no significant benefit to aspirin when it comes to preventing all-cause mortality or cardiovascular mortality, said Dr. Liu. These studies did still find a slight benefit in aspirin for preventing nonfatal heart attacks, but that this benefit was mostly seen in higher cardiovascular risk patients who were also at low risk for bleeding, he added.
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Since then, clinical inertia the slow adoption of new practices by doctors poor communication, and unclear guidance have meant aspirin is still commonly used by those who are not at major risk of developing cardiovascular disease, Nissen said. Over the decades, several groups, such as the American Academy of Family Physicians, the American College of Cardiology, and the American Heart Association, as well as the FDA itself, have disagreed on who low-dose aspirin can help, and how much it can help them. The task force still leaves the decision of whether to use aspirin for prevention up to individuals and their doctors especially for those 40 to 59 years old but refutes the old idea that the drug is totally harmless, Nissen said.
Group by group, bit by bit, people have come around to the idea that the risks are about equivalent to its benefits for most people, Nissen told STAT.
To arrive at its recommendation, the task force reviewed 13 randomized clinical trials on the benefits and risks of aspirin use for preventing the development of cardiovascular disease or dying from it. They found aspirin use was associated with a lower risk of heart attack and stroke but not cardiovascular mortality or all-cause mortality.
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Immediate First Aid Works To Minimize Blood Clotting Triggered By Plaque Ruptures
How should you take aspirin for a heart attack? You’ve always been healthy, but you seemed to run out of steam at your wife’s 60th birthday dinner last week. And now your chest feels heavy, as if you’re in a vise. You take some antacids, even though it’s 7:00 a.m. and you haven’t even had breakfast. But you get no relief, and the pain is spreading to your jaw and shoulder. You call your wife, who takes one look at you and rushes to the phone. After calling 911, she brings you an aspirin and some water.
Your wife got it right: You may be having a heart attack, and you need to get to the hospital fast. You also need to get some aspirin into your system quickly but should you chew the tablet or swallow it?
Millions Should Stop Popping Aspirin For Heart Health Study Warns
The AHA also called attention to bleeding risk in older patients facilitated by aspirin, a type of blood thinner and anticoagulant, as seen in previous studies.
Dr. Jeffrey Berger, director of the Center for the Prevention of Cardiovascular Disease at NYU Langone Health, called the trend shocking in an interview with The Post at the time. His lab studies blood platelets and coagulation as an indicator of heart health.
The fact that many people use aspirin without consulting their health-care provider is shocking, and likely results from the perception that aspirin has little downside, he said.
The AHAs guidelines, similar to the US Preventive Services Task Force update, see that adults over 70 without heart disease, and younger than 40 with increased risk of bleeding, should avoid regular doses of aspirin. Anyone outside those groups should consult their doctor first.
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New Research Shows Benefits No Longer Clearly Outweigh Harms In Adults Without Heart Disease
- Date:
- University of Georgia
- Summary:
- Taking a baby aspirin every day to prevent a heart attack or stroke should no longer be recommended to patients who haven’t already experienced one of these events, new research suggests.
Taking a baby aspirin every day to prevent a heart attack or stroke should no longer be recommended to patients who haven’t already experienced one of these events.
That’s according to a new study published in Family Practice.
Nearly one-quarter of Americans over the age of 40 have reported taking aspirin daily even if they don’t have a history of heart disease or stroke.
That’s a problem, says study author University of Georgia researcher Mark Ebell.
As a physician and epidemiologist at UGA’s College of Public Health, Ebell’s work evaluates the evidence underpinning clinical practice and health behaviors. The current recommendation for taking aspirin as the primary form of heart attack or stroke prevention is limited to adults aged 50 to 69 who have an increased cardiovascular risk.
“We shouldn’t just assume that everyone will benefit from low-dose aspirin, and in fact the data show that the potential benefits are similar to the potential harms for most people who have not had a cardiovascular event and are taking it to try to prevent a first heart attack or stroke,” said Ebell.
But aspirin use has always carried risks, said Ebell, namely bleeding in the stomach and brain.
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Daily Aspirin Linked To Increased Risk Of Heart Failure
November 30, 2021 — Daily aspirin use is associated with an increased risk of new heart failure, a new analysis suggests.
Researchers found that among more than 30,000 patients who were at risk for developing heart failure, the risk for those taking daily aspirin was 26% higher than those not taking it over about 5 years of follow up.
The results though, don’t apply to everyone, but only those with a high risk of heart failure or those already with some symptoms of heart failure, said senior investigator Jan A. Staessen, MD, PhD, professor emeritus at the University of Leuven in Belgium.
It’s thought that heart failure is a condition that tends to create clots, and so in principle, patients should benefit from antiplatelet treatment like aspirin, which tends to decrease clot formation. However, findings from previous studies have been mixed on whether there is benefit from aspirin in these people, the researchers note.
This analysis included six observational studies, with a total of 30,827 participants. Overall, the rate of heart failure per 1,000 person-years for the entire population was 14.5 in the group on daily aspirin versus 5.9 in the group not taking aspirin.
Given the consistency of these results, “our observations suggest that aspirin should be prescribed with caution in patients at risk of HF or having HF,” the investigators concluded.
“If such treatment is initiated in these patients, use low-dose aspirin,” Staessen said.
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Should I Take Aspirin During A Heart Attack Or Stroke
The more important thing to do if any heart attack warning signs occur is to call 911 immediately. Don’t do anything before calling 911. In particular, don’t take an aspirin, then wait for it to relieve your pain. Don’t postpone calling 911. Aspirin won’t treat your heart attack by itself.
After you call 911, the 911 operator may recommend that you take an aspirin. He or she can make sure that you don’t have an allergy to aspirin or a condition that makes using it too risky. If the 911 operator doesn’t talk to you about taking an aspirin, the emergency medical technicians or the physician in the Emergency Department will give you an aspirin if it’s right for you.
Taking aspirin isn’t advised during a stroke, because not all strokes are caused by blood clots. Most strokes are caused by clots, but some are caused by ruptured blood vessels. Taking aspirin could potentially make these bleeding strokes more severe.