by Caroline Petvin
(Health Secrets) Recommendations issued by the U.K.’s Drugs and Therapeutics Bulletin suggest that the regular use of aspirin to prevent heart attack should stop. While patients who already have cardiovascular disease may benefit from aspirin treatment, the risks to healthy individuals are seen to outweigh the benefits.
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Why is aspirin prescribed to healthy people?
There are two forms of heart disease prevention; primary prevention and secondary prevention. Primary prevention attempts to stop cardiovascular disease from occurring in healthy people, while secondary prevention aims to avoid recurrence of cardiovascular disease in people who have already experienced heart attacks or strokes.
Aspirin is currently prescribed as a form of primary prevention, and many doctors recommend that patients take a regular small dose of aspirin to reduce their risk of developing heart disease.
Low dose aspirin for primary prevention may be prescribed to people considered at a higher risk of developing heart disease because they:
Have high blood pressure or high cholesterol
Are males over 45 or postmenopausal females over 55
Are heavy smokers
Have been diagnosed with type 2 diabetes
Have a family history of cardiovascular disease
Why stop taking aspirin for primary prevention?
The results of an aspirin use trial held over six years and involving over 95,000 patients has been published in The Lancet. It concludes that the effect of aspirin treatment on reducing deaths from heart disease is negligible in people who don’t already have some form of heart disease. It also states that the risk of internal bleeding caused by aspirin, either in the intestines or in the brain, outweighs any possible benefits.
This view is backed up by the U.S. Physician’s health study, in which 10,000 healthy male doctors were regularly treated with aspirin and 10,000 were given a placebo. While there were fewer heart attacks among the group taking the aspirin than those taking the placebo, there was no difference in the overall death rate from heart disease.
While serious side effects of aspirin may be fairly rare, taking it regularly can cause bleeding from intestinal ulcers or blood vessels in the brain. This is more likely among older people, so aspirin shouldn’t be used regularly by those over eighty. Regular aspirin use has also been associated with the development of tinnitis.
Why is aspirin used for secondary prevention?
Patients who have already experienced heart attacks or strokes are often prescribed low dose aspirin to reduce the risk of recurrence. This is because aspirin is an antiplatelet agent that stops blood from causing clots that may result in a heart attack or a stroke.