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Old habits die hard. Despite the lack of evidence of any real benefit and new guidelines from the American Heart Association (AHA) and the American College of Cardiology (ACC) not to do so, millions of former American adults in good health always take aspirin daily.
According to the National Institutes of Health (NIH), despite the announcement announced last year of a clinical trial conducted in the United States and Australia on more than 19,000 people aged 65 and over , which concluded that aspirin offered little benefit to healthy seniors and could even increase their risk of bleeding and premature death, it turns out that many people still use it. The said ASPREE study (ASPirin in reducing the number of events in the elderly) found that a daily low-dose aspirin in healthy older people did not prolong life and did not prevent heart disease, physical disability, dementia or stroke, and that Aspirin does not offer the same benefits for healthy seniors as for those who have had a heart attack or stroke. (An aspirin is considered a low dose if it is between 75 and 100 milligrams, but most over-the-counter pills are at 81 milligrams.)
AHA and ACC updated their guidelines last March in response to ASPREE. In the current state of affairs, the AHA and ACC no longer recommend aspirin for the prevention of cardiovascular disease in adults 70 years of age or older or those at higher risk. high bleeding, such as those with gastric (gastric) ulcers.
A new study, supported by the National Institute of Heart, Lung and Blood (NHLBI) NIH, Drs. Colin O'Brien, Stephen Juraschek and Christina C. Wee of the Beth Israel Deaconess Medical Center and Harvard University analyzed the data of thousands of US men and women to determine the number of people taking care of their loved ones. aspirin for the prevention of cardiovascular diseases.
"The survey asked more than 14,000 men and women aged 40 and over if their health care provider had previously prescribed low-dose aspirin or they had chosen to take this aspirin." every day to prevent heart disease. , Reported the NIH. "Among people who did not have cardiovascular disease, about 23% took a daily aspirin as a preventive measure. Nearly 23% of these took a daily aspirin without a referral from a health care provider. Nearly half of survey participants aged 70 or older and not suffering from heart disease reported daily use of aspirin. Aspirin has also been used by a quarter of people with a history of ulcers in the stomach, but no cardiovascular disease. "
According to the NIH, the results– published in July in the & nbsp;Annals of Internal Medicine"Suggest that & nbsp; in the country, about 29 million people who do not suffer from cardiovascular disease are taking aspirin for prevention purposes – and 6.6 million are doing so without recommendation from their health care provider. "
"Studies have shown that aspirin can help some people prevent a second heart attack or stroke. However, taking aspirin also carries a higher risk of bleeding, "notes the NIH. In fact, three randomized controlled trials published in 2018 – ASPREE, ASCEND (study of cardiovascular events of diabetes) and ARRIVE (aspirin to reduce the risk of initial vascular events) – have revealed some benefits from the use of Aspirin for the primary prevention of cardiovascular disease in adults. suffering from diabetes, middle-risk adults and older adults.
"Our findings suggest that a significant portion of adults could take aspirin without their doctor's advice and potentially unknowingly," Wee said in a statement.
"Our findings show a dire need for health professionals to ask their patients what is the continued use of aspirin and advise them on the importance of balancing the benefits and harms. , especially in older adults and those who have ever had a gastric ulcer, "said O. Brien. in a report.
Cardiologist Aaron Tang, MD, of the SSM Health Medical Group in St. Charles County, Missouri, said the new guidelines had changed the way he approached the use of aspirin. "Prior to this study, aspirin was widely recommended for people with established coronary artery disease and people at risk for coronary heart disease. The new study published last year followed people with risk factors for coronary artery disease to determine whether there was a reduction in the number of heart attacks. The results showed an increase in bleeding episodes, but not necessarily fewer heart attacks, "he said. "My personal recommendation is that people take daily aspirin only if they have established coronary artery disease; not for people at risk of heart disease. In general, aspirin is no longer considered a primary method of prevention, but rather as a method of secondary prevention. (Doctors prescribe low-dose aspirin daily to people who have had a heart attack or stroke to help prevent the event. This is what's called "Secondary Prevention". & nbsp; The prescription of aspirin to prevent or delay the onset of the disease is considered a "primary prevention".
Tang said that he was talking to each of his patients about the use of aspirin. "For the patients I see who have been taking daily aspirin for a long time, I do not necessarily tell them not to take it, but I have a conversation with them about the risk of bleeding associated with aspirin. Some have been taking it daily for 20 years and are uncomfortable not to take it. I give my recommendation and finally leave them the decision. This is certainly a conversation you should have with your cardiologist or your primary care physician and that should be tailored to each patient.
According to the NIH, cardiovascular diseases such as coronary heart disease, heart attacks, high blood pressure and stroke are the leading causes of death and disability among older adults in the United States. In the past, experts recommended taking a low-dose daily aspirin to prevent cardiovascular disease because it helps to thin the blood and the known ability of the drug to prevent clots from forming clots. In people with atherosclerotic plaque or fatty deposits in the arteries, these can come off and cause clotting, thereby impeding blood flow to the heart or brain. Although aspirin helps stop this process, studies have suggested that it increases the risk of bleeding from the skull. & Nbsp;
A report published in the journal JAMA Neurology In May, taking low-dose aspirin to prevent heart disease and stroke is associated with an increased risk of skull bleeding in people without a history of these conditions.
In this study, researchers analyzed data from 13 previous studies involving more than 130,000 people aged 42 to 74 years, with no history of heart disease or stroke, who had been given treatment. 39; low-dose aspirin or placebo for the prevention of these conditions.
The researchers found that the use of low-dose aspirin was associated with an increased overall risk of skull bleeding and an increased risk of bleeding in the brain in people of Asian and Asian descent. those having a mass index body of less than 25.
"Clinicians should be very selective in prescribing aspirin for people without known cardiovascular disease," said Dr. Johns Hopkins cardiologist Dr. Roger Blumenthal, who co-chaired the March guidelines. "It's much more important to optimize lifestyle and control blood pressure and cholesterol than to recommend aspirin." Aspirin should be limited to people at higher risk of disease cardiovascular risk and a very low risk of bleeding, "he said.
"Patients should work closely with their doctors to establish their risk of bleeding," said Blumenthal. This risk increases as one gets older or develops kidney disease, heart disease, diabetes, and high blood pressure, "CNN reported. "A history of ulcers or bleeding, especially in the gastrointestinal tract, or anemia are also risk factors. Certain medications, such as nonsteroidal anti-inflammatory drugs, steroids, direct oral anticoagulants, and warfarin, a blood-thinner, may also increase the risk of bleeding. "
The AHA states that low dose aspirin is always recommended to people who have a stroke or heart attack.
The authors of the study also warned doctors. "Since bleeding to the head is often catastrophic and the benefits of low-dose aspirin are not well established, physicians should be cautious when prescribing this drug to people who are not suffering from it. symptomatic cardiovascular disease, "CNN reported.
To discover some of the many uses of aspirin, click on right here.
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Old habits die hard. Despite the lack of evidence of any real benefit and new guidelines from the American Heart Association (AHA) and the American College of Cardiology (ACC) not to do so, millions of former American adults in good health always take aspirin daily.
According to the National Institutes of Health (NIH), despite the announcement announced last year of a clinical trial conducted in the United States and Australia on more than 19,000 people aged 65 and over , which concluded that aspirin offered little benefit to healthy seniors and could even increase their risk of bleeding and premature death, it turns out that many people still use it. The so-called ASPREE study (ASPirine in reducing the number of events in the elderly) showed that a low-dose daily aspirin administered to a healthy elderly person did not prolong life and did not prevent heart disease, physical disability, dementia or stroke. Do not have the same benefits for healthy seniors as for those who have had a heart attack or stroke. (An aspirin is considered a low dose if it is between 75 and 100 milligrams, but most over-the-counter pills are at 81 milligrams.)
AHA and ACC updated their guidelines last March in response to ASPREE. In the current state of affairs, the AHA and ACC no longer recommend aspirin for the prevention of cardiovascular disease in adults 70 years of age or older or those at higher risk. high bleeding, such as those with gastric (gastric) ulcers.
A new study, supported by the National Institute of Heart, Lung and Blood NHI (NHLBI), Drs. Colin O'Brien, Stephen Juraschek and Christina C. Wee of the Beth Israel Deaconess Medical Center and Harvard University analyzed the data of thousands of US men and women to determine the number of people taking care of their loved ones. aspirin for the prevention of cardiovascular diseases.
"The survey asked more than 14,000 men and women aged 40 and over if their health care provider had previously prescribed low-dose aspirin or they had chosen to take this aspirin." every day to prevent heart disease. , Reported the NIH. "Among people who did not have cardiovascular disease, about 23% took a daily aspirin as a preventive measure. Nearly 23% of these took a daily aspirin without a referral from a health care provider. Nearly half of survey participants aged 70 or older and not suffering from heart disease reported daily use of aspirin. Aspirin has also been used by a quarter of people with a history of ulcers in the stomach, but no cardiovascular disease. "
According to the NIH, the results – published in July in the Annals of Internal Medicine"Suggest that in the country, about 29 million people who do not suffer from cardiovascular disease take aspirin daily for prevention purposes – and that 6.6 million do so without recommendation from their health care provider. health."
"Studies have shown that aspirin can help some people prevent a second heart attack or stroke. However, taking aspirin also carries a higher risk of bleeding, "notes the NIH. In fact, three randomized controlled trials published in 2018 – ASPREE, ASCEND (study of cardiovascular events of diabetes) and ARRIVE (aspirin to reduce the risk of initial vascular events) – have revealed some benefits from the use of Aspirin for the primary prevention of cardiovascular disease in adults. suffering from diabetes, middle-risk adults and older adults.
"Our findings suggest that a significant portion of adults could take aspirin without their doctor's advice and potentially unknowingly," Wee said in a statement.
"Our findings show a dire need for health professionals to ask their patients what is the continued use of aspirin and advise them on the importance of balancing the benefits and harms. , especially in older adults and those who have ever had a gastric ulcer, "said O. Brien. in a report.
Cardiologist Aaron Tang, MD, of the SSM Health Medical Group in St. Charles County, Missouri, said the new guidelines had changed the way he approached the use of aspirin. "Prior to this study, aspirin was widely recommended for people with established coronary artery disease and people at risk for coronary heart disease. The new study published last year followed people with risk factors for coronary artery disease to determine whether there was a reduction in the number of heart attacks. The results showed an increase in bleeding episodes, but not necessarily fewer heart attacks, "he said. "My personal recommendation is that people take daily aspirin only if they have established coronary artery disease; not for people at risk of heart disease. In general, aspirin is no longer considered a primary method of prevention, but rather as a method of secondary prevention. (Doctors prescribe low-dose aspirin daily to people who have had a heart attack or stroke to help prevent the event.This is known as "secondary prevention". Prescription of aspirin to protect or delay the onset of the disease is considered "primary prevention".)
Tang said that he was talking to each of his patients about the use of aspirin. "For the patients I see who have been taking daily aspirin for a long time, I do not necessarily tell them not to take it, but I have a conversation with them about the risk of bleeding associated with aspirin. Some have been taking it daily for 20 years and are uncomfortable not to take it. I give my recommendation and finally leave them the decision. This is certainly a conversation you should have with your cardiologist or your primary care physician and that should be tailored to each patient.
According to the NIH, cardiovascular diseases such as coronary heart disease, heart attacks, high blood pressure and stroke are the leading causes of death and disability among older adults in the United States. In the past, experts recommended taking a low-dose daily aspirin to prevent cardiovascular disease because it helps to thin the blood and the known ability of the drug to prevent clots from forming clots. In people with atherosclerotic plaque or fatty deposits in the arteries, these can come off and cause clotting, thereby impeding blood flow to the heart or brain. Although aspirin helps stop this process, studies suggest that it increases the risk of bleeding into the skull.
A report published in the journal JAMA Neurology In May, taking low-dose aspirin to prevent heart disease and stroke is associated with an increased risk of skull bleeding in people without a history of these conditions.
In this study, researchers analyzed data from 13 previous studies involving more than 130,000 people aged 42 to 74 years, with no history of heart disease or stroke, who had been given treatment. 39; low-dose aspirin or placebo for the prevention of these conditions.
The researchers found that the use of low-dose aspirin was associated with an increased overall risk of skull bleeding and an increased risk of bleeding in the brain in people of Asian and Asian descent. those having a mass index body of less than 25.
"Clinicians should be very selective in prescribing aspirin for people without known cardiovascular disease," said Dr. Johns Hopkins cardiologist Dr. Roger Blumenthal, who co-chaired the March guidelines. "It's much more important to optimize lifestyle and control blood pressure and cholesterol than to recommend aspirin." Aspirin should be limited to people at higher risk of disease cardiovascular risk and a very low risk of bleeding, "he said.
"Patients should work closely with their doctors to establish their risk of bleeding," said Blumenthal. This risk increases as one gets older or develops kidney disease, heart disease, diabetes, and high blood pressure, "CNN reported. "A history of ulcers or bleeding, especially in the gastrointestinal tract, or anemia are also risk factors. Certain medications, such as nonsteroidal anti-inflammatory drugs, steroids, direct oral anticoagulants, and warfarin, a blood-thinner, may also increase the risk of bleeding. "
The AHA states that low dose aspirin is always recommended to people who have a stroke or heart attack.
The authors of the study also warned doctors. "Since bleeding to the head is often catastrophic and the benefits of low-dose aspirin are not well established, physicians should be cautious when prescribing this drug to people who are not suffering from it. symptomatic cardiovascular disease, "CNN reported.
To discover some of the many uses of aspirin, click here.