Is There More Harm Than Benefit
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.
Can I Take Aspirin For High Blood Pressure
Asked By : Esther Boney
High blood pressure is a risk factor for heart diseaseand for years, a low dose of daily aspirin has been considered a safe and healthy way to prevent heart disease. Its reasonable, therefore, to associate aspirin with lowering blood pressure, as a key way of preventing heart attacks and strokes.
Who Should Continue Taking Baby Aspirin
People who have had a heart attack or ischemic stroke absolutely need to stay on their aspirin, Simon said.
If you have a history of heart disease or stroke in your immediate family or have had your own history of cardiovascular disease or atherosclerotic disease, your doctor may recommend you continue taking a daily low-dose or baby aspirin.
This is also true for people who have had stents or coronary bypass surgery.
If you are at all confused, consult your doctor.
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Whats The Bottom Line
The best way to know if you can benefit from aspirin therapy is to ask your health care provider. You should not start aspirin on your own.
Written by American Heart Association editorial staff and reviewed by science and medicine advisers. See our editorial policies and staff.
Last Reviewed: Mar 20, 2019
Nsaids And Cardiovascular Disease: Minimizing The Risks
There are several factors to consider when evaluating the potential risk of NSAID therapy. The first is the duration of treatment. The risk of having a heart attack or stroke is extremely small over a short course of therapy , such as would be the case in treating acute pain from a musculoskeletal injury like tendonitis. Another important consideration is dose and frequency. The risk tends to increase with higher doses and increased frequency. The third factor is whether the person has existing cardiovascular disease. In people without known cardiovascular disease, the absolute increase in risk is incredibly small .
My general principles for NSAID use are:
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Advice Shifting On Aspirin Use For Preventing Heart Attacks
Lindsey Tanner Associated PressOct. 12, 2021
Older adults without heart disease shouldnt 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 havent 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 its the right choice for them, said task force member 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.
Aspirin No Longer Recommended To Prevent 1st Heart Attack Stroke For Most Adults Over 60
The new guidelines do not change for people who have had a heart attack.
For years, doctors recommended people in their 50s start taking baby aspirin every day to protect against heart attacks and stroke. But in recent years, with new evidence of the possible harm of daily aspirin, health experts shifted those recommendations.
In major new guidance, an influential physician task force no longer recommends daily aspirin to prevent a first heart attack or stroke among people 60 and older. Meanwhile, the new guidance said people 40 to 59 should only take it if they have a high risk of cardiovascular disease, and in consultation with a doctor. There is little benefit in continuing aspirin beyond the age of 75 years old, experts concluded.
The new guidance comes from the United States Preventive Services Task Force , an influential physician group that helps guide medical best practices.
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Why Have Adults Been Taking Low
Cardiovascular disease is the leading cause of death in the U.S., accounting for about one in three deaths, according to the Preventive Services Task Force. Each year, an estimated 605,000 Americans have a first heart attack and about 610,000 experience a first stroke. So prevention is key. And, for decades, doctors have often advised older adults to take daily baby aspirin to prevent heart attacks and strokes.
How Did Evidencenow Evaluate Whether Practices Followed This Pcor Evidence
The measure used by EvidenceNOW to evaluate aspirin use reflects the percentage of patients with heart disease , patients with a history of a heart attack, and patients with a history of a stroke who use aspirin or a similar drug.
The National Quality Forum also endorsed this measure , which is used by the Centers for Medicare & Medicaid Services.
The EvidenceNOW goal for primary care practices in the study is to have at least 70 percent of patients for whom aspirin use is recommended be taking it or a similar drug.
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Where Did The Story Come From
This was a conference abstract of a study carried out by researchers from Leiden University Medical Center and Nijmegen University Sanquin Research both in the Netherlands. It was funded by Leiden University Medical Center and the Netherlands Heart Foundation.
The summary was presented this week at a meeting of the American Heart Association. The research has, to the best of our knowledge, not yet been peer-reviewed.
The study was covered widely in the media. Many newspapers tended to overstate the findings and did not mention the study has not yet been published. Though the Daily Mail did include useful comments from independent experts in the UK, while the Daily Telegraph mentioned the risk of side effects from aspirin.
The medias leap that the observed reduction in platelet reactivity would result in reduced risk of heart attack is an assumption that should not be made at the current time.
Aspirin Therapy, heart attack and stroke
For decades, millions of Americans have been advised to take low dose aspirin daily to prevent heart attacks and strokes. But new research is raising questions about this common practice.
Its not that aspirin doesnt work to keep the heart healthy. It does. Its just that the dose your doctor wants you to take may need to change in order to be right for you. Doctors recommend aspirin because it helps to prevent clots from forming that can block blood flow to the heart or brain, causing heart attacks and strokes.
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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Nsaid Pain Relievers Such As Naproxen And Ibuprofen
If you have atrial fibrillation and are on blood thinners to lower your risk of blood clots and stroke, beware of nonsteroidal anti-inflammatory drugs . NSAIDs include common pain relievers naproxen and ibuprofen .
These drugs, which are available over the counter and are used commonly to relieve the aches and pains that all of us have, are also blood thinners, says Dr. Ellis. If you combine them with prescription blood thinners, you could have serious bleeding.
What Should You Do If You Have Heart Palpitations
If you begin to experience chest pains or tightness, you should seek medical attention. Heart palpitations could be a symptom of a serious heart-related condition. You shouldnt ignore them.
Learn about your family history. If you have a family member that has had any type of heart disease, this increases your risk of having a heart attack.
Unless your doctor instructs you otherwise, call 911 or go to the emergency room if you feel sudden, intense heart palpitations. This is especially true if theyre accompanied by:
- shortness of breath
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Natural Safe Alternatives To Nsaids
If youre going to use a pain-relieving drug, choose aspirin. It is the safest, although it can cause stomach bleeding. Its better to consider these natural, safe and effective alternatives:
- Turmeric reduces pain from muscle pulls and other injuries. A typical turmeric supplement dose is 400-600 mg.
- Willow bark contains salicin. This is the same compound in aspirin that relieves pain and inflammation. It treats headache, low back pain, menstrual cramps, fever, flu, tendonitis, bursitis, and osteoarthritis. Take 1-3 grams.
- Capsaicin is the compound in hot peppers that makes them spicy. It is applied as a topical treatment for arthritis pain.
- Bromelain is an extract of pineapple. It is effective in treating inflammation associated with rheumatoid arthritis. Take 250 mg twice daily.
- Magnesium can be extremely effective for migraines. A recommended dosage is 400-600 mg.
These natural products allow many people to throw away their NSAIDsand their worries about giving themselves a heart attack.
Aspirin And Gender Differences
Well known differences exist in the epidemiology of vascular events in men and women. Men are more prone to stroke and MI, yet women are more likely to die from these events than men.12 Similarly, meta-analysis results suggest that there are also gender differences in the effects of aspirin on CVD, whereby risk of MI appears to be reduced in men and risk of stroke appears to be reduced in women.28,37 Current guidelines for the use of aspirin for CVD prevention take these differences into consideration. Aspirin use in males is primarily intended for the prevention of coronary artery disease, while in females, prevention of stroke is the main target.12 The reason for differences in the effect of aspirin therapy by gender is currently unknown, but evidence suggests that there may be some biological basis for these differences. For example, baseline platelet reactivity is greater in women than in men, with higher residual reactivity following aspirin treatment in women.38 As such, physicians should also be sure to consider gender-specific risks, benefits, and guidelines for aspirin therapy prior to making patient recommendations.
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What Should Patients Do
Doctors are already aware from previous studies that non-steroidal anti-inflammatory drugs could increase the risk of heart problems and strokes.
And current UK guidelines state that Nsaids must be used carefully in people with heart problems and in some cases they should not be used at all.
Dr Mike Knapton of the British Heart Foundation, suggests patients and doctors weigh up the risks and benefits of taking high doses of these common painkillers, particularly if they have survived a heart attack or are at higher risk.
Meanwhile, GP leader Prof Helen Stokes-Lampard said it was important that any decision to prescribe was based on a patients individual circumstances and medical history, and was regularly reviewed.
She said that as new research was published, it was important that it was taken on board to help inform guidelines.
But she added: The use of Nsaids in general practice to treat patients with chronic pain is reducing, and some of the drugs in this study are no longer routinely prescribed in the UK, such as coxibs, as we know that long-term use can lead to serious side-effects for some patients.
Aspirin For Heart Attack Prevention
Aspirin can help prevent heart attacks in people with coronary artery disease and in those who have a higher than average risk. Only low dose, usually just 1 a day, is needed. But people who think they may be having an attack need an extra 325 mg of aspirin, and they need it as quickly as possible. For the best results, chew a single full-sized 325-mg tablet, but don’t use an enteric-coated tablet, which will act slowly even if chewed. And don’t forget to call 911, then your doctor. It’s a contemporary update on the old reminder to take two aspirin and call in the morning and it’s good advice to chew over.
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Image: ironstealth/Getty Images
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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.
What Pcor Evidence Did Evidencenow Use
Here are the PCOR findings used by EvidenceNOW for aspirin use:
In 2011, the American Heart Association and the American College of Cardiology Foundation used PCOR evidence to develop guidelines on aspirin use in patients with heart disease and others who are at risk of heart attack or stroke .
Recommendation: Based on the evidence, the panel recommended long-term, low-dose aspirin therapy for patients with heart disease. For patients intolerant or allergic to aspirin, clopidogrel can be used as an alternative.
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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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