Bag the Aspirin

July 16th, 2009 | Sources: Lancet, MedPageToday

Subjects:

The millions of folks with no cardiac history who have been diligently popping baby aspirin to prevent future cardiovascular events might as well flush ‘em down the toilet, according to the results of a meta-analysis performed by Oxford University scientists.

shouldntabought10yearsworthIn such people, aspirin did reduce the combined risk of heart attack, stroke, and vascular death from 0.57% per year to 0.51%, a significant finding, but it also bumped the risk of gastrointestinal and all extracranial bleeding from 0.07% per year to 0.10%, negating any overall benefit.

Colin Baigent and colleagues oversaw the trial, known as Antithrombotic Trialists’ Collaboration, and published their findings in Lancet.

Current American Heart Association and US Preventive Services Task Force guidelines recommend baby aspirin for primary cardioprevention in those deemed to have a moderately high risk for developing heart disease.

The “current guidelines may need to be reviewed,” Biagent stated matter-of-factly to MedPageToday. For primary prevention, “the main strategies ought to be stopping smoking — if people smoke – and then if further measures are needed, lowering blood pressure, lowering cholesterol.” Baigent added.
 
The scientists had pooled data from 6 randomized, controlled trials of aspirin for the primary prevention of cardiovascular disease. Collectively, the trials had enrolled 95,000 individuals.

Subset analyses involving gender, older age, and a history of either diabetes or high blood pressure revealed nothing to chirp about. In these groups as well, any benefits in cardiovascular risk were offset by increased bleeding.

By the way, Biagent’s group also took a quick peek at secondary prevention, and confirmed that the benefits of aspirin outweigh the risks in individuals with a history of cardiac disease.


 

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