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Harvard researchers reported Monday that millions of people taking aspirin to prevent a heart attack may need to rethink the active ingredient.
A low-dose daily aspirin is recommended for people who have had a heart attack or stroke and for those who have been diagnosed with heart disease.
But for the rest in good health, this advice has been reversed. The guidelines published this year have excluded the routine use of aspirin in many older people who do not already have heart disease – and said it was reserved for some younger patients under the orders of a doctor.
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According to a new study by Harvard and the Beth Israel Deaconess Medical Center, some 29 million people aged 40 and over were taking an aspirin daily despite the absence of known heart disease in 2017, according to the latest data available. About 6.6 million of them did it on their own – a doctor never recommended it.
And nearly half of people over 70 who do not have heart disease – estimated at about 10 million people – took aspirin daily for preventive purposes, the researchers reported in Annals of Internal Medicine.
"Many patients are confused about this," said Dr. Colin O'Brien, Senior Resident in Internal Medicine at Beth Israel, who led the study.
After all, for years, doctors have been urging people to use the anticoagulant properties of aspirin to reduce the risk of a first heart attack or stroke. Then, last year, three new surprising studies challenged this dogma. These studies were among the longest and longest to test for aspirin in people at low or moderate risk of heart attack, and found only marginal benefit, if any, especially in people elderly. However, aspirin users have had digestive tract hemorrhage and other side effects. .
In March, these findings prompted the American Heart Association and the American College of Cardiology to change their guidelines:
– People over the age of 70 who do not have heart disease – or who are younger but have an increased risk of bleeding – should avoid daily aspirin for prevention.
– Only certain individuals aged 40 to 70 who do not already have heart disease are at a high enough risk to warrant 75 to 100 milligrams of aspirin daily, at the discretion of the physician.
Nothing has changed for survivors of a heart attack: aspirin is still recommended to them.
But there is no way to know how many otherwise healthy people have heard about the modified recommendations.
"We hope more primary care physicians will discuss the use of aspirin with their patients and that more patients will discuss this with their doctor," said O'Brien.
Credit: Associated Press (AP) | Photo credit: (AP)
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