Issues With Aspirin for Heart Patients


A daily dose of aspirin has long been touted as a means of preventing heart attacks and strokes. While aspirin is a proven methodology for some heart patients, there can be issues with aspiring for others. In fact, new research shows that many Americans are inappropriately downing a daily dose.

An estimated  69,000 American adults have been prescribed a long-term daily aspirin regime to preclude cardiovascular problems. However, the research team determined that 12 percent of them should not be taking the aspirin.

The researchers, led by Dr. Ravi Hira, a cardiologist from Baylor College of Medicine in Houston, found that the aspirin use was creating risks of other problems that overshadowed the risks of heart issues. Overuse of aspirin is known to cause serious gastrointestinal bleeding or hemorrhagic stroke (bleeding in the brain) as side effects.

Published online in the Journal of the American College of Cardiology, the study is based on medical records from over 68,800 patients at 119 U.S. cardiology practices. The records included heart patients as well as people with high blood pressure who had not yet developed heart disease.

The study showed that almost 12 percent of the patients whose files were reviewed seemed to have been prescribed the daily aspirin regime unnecessarily or inappropriately. The researchers determined that the risks of having heart trouble or a stroke were not adequate to justify the long-term aspirin use.

“Aspirin is not a medication that comes without risks,” Hira pointed out. People sometimes dismiss aspirin’s bleeding risks, he noted, largely because the drug is so readily available and commonly used. But there is a difference between occasional use and regular doses.

Patients who previously had a heart attack or stroke benefit from a daily aspirin to thin their blood and cut the chance of a recurrence. But, for people who have not had a stroke or heart attack before, taking an aspirin every 24 hours, so-called “primary prevention,” has a smaller potential benefit and the blood thinning could create other health problems.

The temptation to pop a pill as a simple solution can be great. So, people who fear heart problems often welcome the idea of taking a daily aspirin or other pill to control high blood pressure, diabetes or cholesterol. They think that they are protecting their heart with one gulp versus more proactively changing their diet or exercising. “It’s probably easier to take a pill than to change your lifestyle,” Hira pointed out. But, the new findings indicate that pills alone do not cut it or create side effects and that some users could be making the wrong choice.

Guidelines from the American Heart Association and other groups say doctors should consider patients’ risk factors for developing heart disease – including their age, blood sugar level, blood pressure, cholesterol reading and smoking habits. Then, weigh those factors against other health indicators and the patients’ risk of bleeding. For example, someone who has have a stomach ulcer would have a far greater risk of a gastrointestinal bleeding complication from aspirin than someone with no history of ulcers. Furthermore, women and patients who are younger are more likely to not need aspirin as much as men and seniors.

The U.S. Food and Drug Administration recently weighed in on the issues with aspirin for heart patients. They advised people not to use aspirin to try to prevent a first-time heart attack or stroke. The important thing, Hira pointed out, is for people to talk to the doctor before starting on a daily low-dose aspirin on their own.

By Dyanne Weiss

Journal of the American College of Cardiology
U.S. News