Thursday, June 20, 2024

Aspirin For Heart Attacks

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The Advent Of Systematic Overviews Of Trials

The latest health guidance on taking aspirin as heart attack, stroke preventative

The findings in our trial led us and others to set up and report further randomized controlled trials. In all of these, mortality was lower in the aspirin groups than in the placebo groups, but in none were these differences statistically significant. We found the consistency of the results of the six trials that were available impressive, and believed that they were virtually conclusive in support of aspirin. However, two developments in the wider scene alarmed us. One was a claim based on the results of a small trial in which statistically significant differences were interpreted as evidence that aspirin was of value only in unstable angina, and not in heart attack 9 the other reason for our concern was another claim based on small numbers that aspirin was useful in men but not in women.10

These retrospective conclusions based on small numbers seemed to us to be untenable, and likely to reflect the play of chance, so we conducted our own, somewhat primitive, meta-analysis of all the evidence available at that time.

What Should Younger People Who Have A Risk Of Heart Disease Do

They should talk with their doctors and decide whether a daily dose of baby aspirin benefits them.

Patients ages 40 to 59 who have a greater than 10% risk of having a stroke or heart attack over 10 years should have a patient-centered discussion with their doctor about whether to start using aspirin. There may be a small net benefit for them. This should be a patient decision based on bleeding risk versus cardiovascular risk, Simon said.

Patient Population Under Consideration

This recommendation applies to adults 40 years or older without signs or symptoms of CVD or known CVD who are not at increased risk for bleeding . In this recommendation statement, CVD risk and the net benefits of aspirin use are discussed using the terms men and women, although it is likely that CVD risk and net benefit estimates are driven by sex rather than gender identity.

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How Much What Type And How To Take It

The current recommendation for people who may be having a heart attack is to chew and swallow one non-coated adult aspirin as soon as advised to do so by a medical professional. Chewing or crushing the aspirin gets it into your bloodstream more quicklywithin four to five minutesand researchers have measured a significant effect on platelets within that short period of time.

Swallowing a whole aspirin with water, as you normally would, takes 10 to 12 minutes to achieve the same effect. This time difference may seem small, but, once again, minutes count when your heart is at risk.

Is There More Harm Than Benefit

Aspirin for heart attack: Chew or swallow?

Previous guidelines from the United States Preventive Services Task Force warned against taking aspirin for the primary prevention of heart disease unless youre at an elevated risk typically if youre 50 to 69 years old with a 10 percent or greater chance of having a heart attack or stroke within the next 10 years.

There is good reason to be wary of aspirin, warns Michos, particularly for women. The Womens Health Study was a large trial that looked at whether women with no history of heart disease would benefit from taking a low dose of aspirin. Researchers found that in the overall group of women, aspirin didnt reduce the risk of heart attacks, but it did increase the risk of bleeding. Some benefit was seen for women over the age of 65.

So not only was there lack of benefit for the younger women taking aspirin, but there was also a question of harm, says Michos. Its important for people to realize that just because aspirin is over-the-counter does not mean it is necessarily safe. Many patients take aspirin because they think its good for their hearts, but it carries some serious risks.

The best way to assess your risk level is to talk to your doctor about it. Your doctor can help you weigh the risks and benefits to determine if low dose aspirin therapy is right for you.

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What Are The Guidelines For Aspirin Therapy

Always talk to your healthcare provider before starting aspirin therapy for heart disease. Your provider will tell you whether aspirin is good for your heart and how much you should take.

One baby aspirin per day is enough to help prevent heart attack or stroke. Higher doses will increase your risk of bleeding. If you do not have many risk factors for heart disease, are older, or have a high risk of life-threatening bleeding, then aspirin therapy may not be right for you.

Remind Me What Are The Different Kinds Of Stroke

  • An ischemic stroke is the result of decreased blood flow to the brain. It occurs when a vessel supplying blood to the brain is blocked. About 87% of all strokes are the result of ischemic strokes.
  • A hemorrhagic stroke is the result of a blood vessel in the brain leaking or rupturing, resulting in bleeding in the brain.
  • A mini-stroke or transient ischemic attack is caused by a temporary lack of blood flow to the brain. A TIA is an important warning sign and patients should take them seriously.
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    Is Daily Aspirin Right For You

    Doctors typically prescribe daily aspirin therapy for people who have certain cardiovascular risk factors.

    You might benefit from taking aspirin every day if you answer yes to one or more of the following questions:

    • Have you previously had a heart attack?
    • Have you previously had a clot-related stroke?
    • Have you had a stent inserted in a coronary artery?
    • Do you have chest pain caused by angina?
    • Have you had coronary bypass surgery?
    • Are you a man over 50 or a woman over 60 with diabetes and at least one other heart disease risk factor?
    • Do you have a family history of heart attacks?

    If you think youre at risk, make an appointment to discuss daily aspirin with a doctor.

    Aspirin As A Primary Prevention Measure

    Experts say healthy adults shouldn’t use daily aspirin to prevent heart attacks | WNT

    The suggested changes say that no one over the age of 60 should take aspirin as primary prevention against cardiovascular disease. Primary prevention is a term for avoiding a first heart attack, ischemic stroke or other type of cardiovascular issue. Low-dose aspirin might be considered for individuals age 40 to 59 who are at moderate risk of developing cardiovascular disease and do not have an increased risk of bleeding.

    Bitar says his moderate- to high-risk patients are evaluated using the Framingham scoring system, which helps to predict a persons risk of heart attack and stroke. The system measures factors like HDL cholesterol, total cholesterol, blood pressure, age, sex and smoking habits, he said.

    For years, aspirin was considered a safe way to prevent heart disease because it served as an over-the-counter medication that thins the blood, thus reducing the risk of clot formation a precursor of heart attack and stroke. But experts now warn about the risk of internal bleeding from consuming aspirin.

    Taking aspirin on a daily basis irritates the lining of the stomach and bowels, which can lead to bleeding in the digestive system, said Bitar. For those who have not experienced a cardiovascular event, the benefits of a daily aspirin do not outweigh the risk of bleeding, he says.

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    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?

    Other Ways To Reduce Your Risk For Heart Disease

    Although non-modifiable risk factors such as age and genetics weigh heavily on a persons chances of developing cardiovascular disease, there are measures individuals can take to reduce their risk factors. Bitar encourages his patients to incorporate lifestyle changes such as eating a healthy, plant-based or Mediterranean diet, getting regular exercise, avoiding smoking, improving sleep habits and reducing alcohol use.

    Blood pressure control, weight loss and well-controlled diabetes are some of the other primary and, for many patients, secondary preventive measures that can significantly reduce your chances of cardiovascular disease altogether or help you avoid a second cardiovascular event, said Bitar.

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    Fact: Once Your Doctor Decides That Daily Use Of Aspirin Is For You Safe Use Depends On Following Your Doctor’s Directions

    There are no directions on the label for using aspirin to reduce the risk of heart attack or clot-related stroke. You may rely on your health professional to provide the correct information on dose and directions for use. Using aspirin correctly gives you the best chance of getting the greatest benefits with the fewest unwanted side effects. Discuss with your health professional the different forms of aspirin products that might be best suited for you.

    Aspirin has been shown to lower the risk of heart attack and stroke in patients who have cardiovascular disease or who have already had a heart attack or stroke, but not all over-the-counter pain and fever reducers do that. Even though the directions on the aspirin label do not apply to this use of aspirin, you still need to read the label to confirm that the product you buy and use contains aspirin at the correct dose. Check the Drug Facts label for “active ingredients: aspirin” or “acetylsalicylic acid” at the dose that your health professional has prescribed.

    Remember, if you are using aspirin everyday for weeks, months or years to prevent a heart attack, stroke, or for any use not listed on the label without the guidance from your health professional you could be doing your body more harm than good.

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    It might be time to rethink that daily aspirin regimen.

    US health experts have urged a revision to the routine prescription of daily, low-dose aspirin to prevent heart attack and stroke, as studies now show that the practice may put healthy adults at risk of other serious complications.

    The US Preventive Services Task Force submitted a draft of new recommendations on Tuesday, which remain in review by peer researchers through Nov. 8.

    The panels report maintained that low-dose aspirin, at 81-100 milligrams per dose, can reduce the risk of cardiac events and stroke, but at the same time increases major GI bleeding, extracranial bleeding and intracranial bleeding, they wrote.

    Evidence also points to a long-term reduction in the incidence of colorectal cancer and mortality, but results are limited as to whether the benefits outweigh the risks for healthy patients with no previous signs of heart disease.

    The new instructions would apply in particular to those aged 60 and below who are considered high risk for heart disease or stroke. Meanwhile, those on a daily aspirin regimen due to a prior heart attack should decide with a physician whether they should continue.

    Cardiac history aside, the national task force now discourages anyone older than 60 to reconsider taking the daily dose, as bleeding risks increase significantly with age.

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    Heart Attack Survivor Stories


    “I am thankful for each day and the opportunities it brings to share my experiences with others.”

    KEN L

    “Ive changed my diet to minimize fat and salt. Im learning to read labels and make healthy choices.”


    “It all comes down to listening the cardiologists listening to us, and not just with their stethoscopes and us listening to the cardiologists. Without both of these, there are no winners!”


    “I now take a low dose Bayer Aspirin regimen, and I was told that the aspirin I was given during my heart attack helped save my life! Thanks for being there for me Bayer!”

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    The independent panel of disease-prevention experts analyzes medical research and literature and issues periodic advice on measures to help keep Americans healthy. Newer studies and a reanalysis of older research prompted the updated advice, Wong said.

    Aspirin is best known as a pain reliever but it is also a blood thinner that can reduce chances for blood clots. But aspirin also has risks, even at low doses mainly bleeding in the digestive tract or ulcers, both of which can be life-threatening.

    Lauren Block, an internist-researcher at Feinstein Institutes for Medical Research in Manhasset, N.Y., said the guidance is important because so many adults take aspirin even though they have never had a heart attack or stroke.

    Block, who is not on the task force, recently switched one of her patients from aspirin to a cholesterol-lowering statin drug because of the potential harms.

    The patient, 70-year-old Richard Schrafel, has high blood pressure and knows about his heart attack risks. Schrafel, president of a paperboard-distribution business, said he never had any ill effects from aspirin, but he is taking the new guidance seriously.

    Rita Seefeldt, 63, also has high blood pressure and took a daily aspirin for about a decade until her doctor told her two years ago to stop.

    He said they changed their minds on that, recalled the retired elementary school teacher from Milwaukee. She said she understands that science evolves.

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    How Should I Take It

    First, tell your doctor if you are allergic to aspirin, ibuprofen, or naproxen. If you get the go-ahead to start an aspirin routine, then:

    • Donât take it on an empty stomach. Take aspirin with a full glass of water with meals or after meals to prevent stomach upset.
    • Donât break, crush, or chew extended-release tablets or capsules — swallow them whole. Chewable aspirin tablets may be chewed, crushed, or dissolved in a liquid.
    • Aspirin should never be taken in place of other medications or treatments recommended by your doctor.
    • Never take it with alcohol. That increases your chance of stomach bleeding.

    Ask your doctor what other medicines you can take for pain relief or minor colds while you take aspirin. Read the labels of all pain relievers and cold products to make sure theyâre aspirin-free. Other drugs with aspirin or nonsteroidal anti-inflammatory drugs may cause bleeding when taken with your regular aspirin therapy.

    Before any surgery, dental procedure, or emergency treatment, tell the doctor or dentist that youâre taking aspirin. You might need to stop taking it for 5 to 7 days before your procedure.

    However, donât stop taking this medicine without first consulting with your doctor.

    What Caused The Low

    Advice shifting on aspirin use for preventing heart attacks

    After last meeting on the topic in 2016, the USPSTF recently reconvened to discuss the role that low-dose aspirin should and shouldn’t play in the prevention of heart disease and its complications. New recommendations that were drafted and released in October 2021 are now finalized as of April 26, 2022.

    The new recommendations set by the task force are that:

    • Taking daily low-dose aspirin for primary prevention of heart disease in adults 60+ shows no clear benefit.
    • Taking daily low-dose aspirin for primary prevention of heart disease in adults 40-59 who have a 10-year atherosclerotic cardiovascular disease risk of 10% or higher may have a small benefit.

    “Primary prevention means you’re at risk for heart disease and preventive steps are needed to reduce this risk, but there’s no evidence that your arteries are actually diseased and you haven’t yet had a heart attack or stroke,” says Dr. Septimus.

    Rather than taking low-dose aspirin every day, your doctor may recommend reducing your heart disease risk by making lifestyle changes, such as:

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    Aspirin No Longer Recommended To Prevent First Heart Attack Stroke

    April 27, 2022 â People who are age 60 or older should not begin taking daily aspirin to prevent a first heart attack or stroke, according to new recommendations from the U.S. Preventive Services Task Force.

    Whatâs more, people ages 40-59 should take daily aspirin only if they have a high risk of cardiovascular disease and have talked with their doctor about whether to start taking aspirin to prevent a heart attack or stroke.

    After age 75, there is little benefit in continuing daily aspirin use.

    âBecause the chance of internal bleeding increases with age, the potential harms of aspirin use cancel out the benefits,â Michael Barry, MD, the task forceâs vice chair and director of the Informed Medical Decisions Program at Massachusetts General Hospital, said in the statement.

    Heart disease and stroke are the leading causes of death in the U.S., making up more than 1 in 4 deaths, the task force said. Although 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.

    For years, doctors have recommended that patients in their 50s begin taking baby aspirin daily to protect against heart attacks and strokes. But in recent years, new evidence has highlighted the possible harms of daily aspirin, and doctors began shifting their recommendations.

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