Aspirin
Can Prevent First Heart Attack, Study Finds
Seek
An Expert's Advice Before Choosing This Prevention Measure
Research
and experience has proven aspirin's ability to prevent second heart
attacks and stroke.
Now,
a new analysis using data from the Physician's Health Study and four
other large studies shows significant reduction in first heart attacks
among aspirin users, according to a report in the Archives of
Internal Medicine.
"Aspirin reduces the risk of a first
attack in healthy people by 32 percent," says study co-author Dr.
Patricia Hebert, a cardiologist at Yale University.
The study researchers also found aspirin
reduced the risk of all major cardiac events by 15 percent.
Dr. Hebert and her team collected data
from the five studies including 55,580 people, 11,466 of whom were women,
"When you consider whether or not
a patient should be receiving aspirin to prevent a heart attack, you
really need to think about their risk of having a heart attack,"
Dr. Hebert says.
Learn
Your Risk for Heart Attack
Physicians
need to look at a person's 10-year risk of having a first heart attack,
and if that risk is 10 percent or higher, then the individual should
be taking aspirin daily, Dr. Hebert notes. This view matches the recommendations
of both the US Preventive Services Task Force and the
American Heart Association.
Dr. Hebert says a risk profile is based
on a number of factors, including age, sex, weight, family history,
diabetes, smoking, and blood pressure and cholesterol levels.
"Aspirin to prevent a first heart
attack is underused," Dr. Hebert says. People should talk with
their physicians about what their risk for heart attack is to see if
they should be taking aspirin daily, she advises.
Physicians often recommend a baby aspirin
tablet which is 81 mg. However, the amount of aspirin prescribed may
vary by physician practice.
"If more people took daily aspirin,
it is estimated that 150,000 cardiovascular deaths could be prevented
each year," Dr. Hebert says.
"If your risk of a first heart attack
is 10 percent or more, than the chances are that the benefits of aspirin
therapy will outweigh the risks," Dr. Hebert says. Risks of aspirin
therapy can include gastrointestinal bleeding and a small risk of hemorrhagic
stroke.
Patients with similar risk profiles for
a heart attack might also want to take cholesterol-lowering drugs, called
statins, Dr. Hebert says. "Most people who are eligible for aspirin
therapy would also be eligible for statins," she says.
The researchers add there is not enough
research data to determine if aspirin also prevents ischemic stroke
or vascular death.
Adopt
a Heart-Healthy Lifestyle, Expert Says
Dr.
David Katz, a public health expert at Yale University, says the study
gives a good overview that reinforces what has been learned thus far.
He adds there are approaches to preventing
heart disease that have no risks associated with them. These include
eliminating risk factors, such as smoking, and being active and eating
a healthy diet.
"These go a long way to preventing
the cardiac risk factors that would cause you to have a 10 percent risk
for a heart attack," he says.
"It comes down to a choice,"
Dr. Katz adds. "People who are willing to commit to the harder
work of living a health-promoting lifestyle may never need aspirin to
prevent heart disease.
"Those who can't make that commitment,
or who have risk factors because of a genetic component or despite a
healthful lifestyle, will find aspirin a very useful strategy for preventing
heart disease, because it is very effective and not very toxic,"
Dr. Katz says.
Dr. Katz agrees aspirin therapy is underused.
"Both doctors and patients tend to be concerned about the potential
toxicity of treatment. But what is ignored is the potential toxicity
of non-treatment," he says.
While there are side effects to using aspirin,
for those at risk for a heart attack, not taking aspirin carries a substantial
risk of having a heart attack, Dr. Katz says.
Always consult your physician for more
information.
Online
Resources
American
Heart Association Centers
for Disease Control and Prevention (CDC)
HealthierUS.Gov
National
Heart, Lung, and Blood Institute (NHLBI) National
Institutes of Health (NIH) US
Food and Drug Administration |
November 2003
In
This Issue:
Aspirin
Can Prevent First Heart Attack, Study Finds
Learn
Your Risk for Heart Attack
Adopt
a Heart-Healthy Lifestyle, Expert Says
Aspirin
Used to Prevent Second Heart Attack
FDA
Suggests Caution Regarding Aspirin Use
Online
Resources
Find
a St. John's Mercy Physician
In
Other News About Your Heart Health:
Aspirin
Used to Prevent Second Heart Attack
The
American Heart Association (AHA) recommends aspirin
use for patients who have had a myocardial infarction (heart attack),
unstable angina, ischemic stroke (caused by blood clot), or transient
ischemic attacks (TIAs or "little strokes"), if not contraindicated.
The
AHA says this recommendation is based on sound
evidence from clinical trials showing that aspirin helps prevent
the recurrence of such events as heart attack, hospitalization for
recurrent angina, and second strokes.
Studies
show aspirin also helps prevent these events from occurring in people
at high risk, a primary prevention tool.
The
AHA says individuals should not start aspirin therapy
without first consulting their physician. The risks and benefits
of aspirin therapy vary for each person.
Always
consult your physician for more information.
FDA
Suggests Caution Regarding Aspirin Use
The US Food and Drug Administration (FDA) states
that aspirin has been shown to be helpful when used daily to lower
the risk of heart attack, clot-related strokes, and other blood
flow problems. Many medical professionals prescribe aspirin for
these uses.
The
FDA reports that there may be a benefit to daily
aspirin use for individuals with heart or blood vessel disease,
or if a person has evidence of poor blood flow to the brain.
However,
the risks of long-term aspirin use may be greater than the benefits
if there are no signs of, or risk factors for, heart or blood vessel
disease, the FDA states.
Every
prescription and over-the-counter medicine has benefits and risks,
even such a common and familiar medicine as aspirin.
Aspirin
use can result in serious side effects, such as stomach bleeding,
bleeding in the brain, kidney failure, and some kinds of strokes.
No medication is completely safe.
Always
consult your physician for more information.
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