IF YOU’RE AN ADULT IN your late 60s or 70s who’s physically healthy, mentally sharp and trying to stay that way, taking a daily low-dose aspirin probably won’t help that much, new research shows. Until now, there hasn’t been much guidance for healthy older people trying to weigh the possible preventive effects of aspirin against its known increased risks of bleeding.
On Sept. 16, findings from a large new study on preventive aspirin use appeared in the New England Journal of Medicine. The three-pronged clinical trial encompassed more than 19,000 older adults in the U.S. and Australia. Participants were living independently, without heart disease, dementia or diabetes when they enrolled between 2010 and 2014 in the study sponsored by the National Institute on Aging.
Participants, whose average age was 74, were randomly assigned to take either a daily low-dose 100 milligram aspirin (the international equivalent of a standard 81 mg baby aspirin) or a placebo. Over a roughly five-year period, researchers followed these healthy seniors to see whether regular preventive aspirin extended their lifespan free of disability or dementia. However, there was no real difference between people on aspirin and those on a placebo, results showed.
For people living with both Type 2 diabetes and heart failure, taking an aspirin each day appears to lower the risk of dying or being hospitalized for heart failure, according to research being presented at the American College of Cardiology’s 67th Annual Scientific Session. But the data also reveal aspirin use may increase the risk of nonfatal heart attack or stroke, a somewhat contradictory finding that surprised researchers.
The study is the first to assess aspirin as a preventive measure for patients who have both diabetes and heart failure. Aspirin, a blood thinner, is strongly recommended for patients who have previously had a heart attack or stroke, but guidelines are unclear regarding its use as a preventive measure for patients who have cardiovascular risk factors but no history of heart attack or stroke. Previous studies in people who have not had those types of health events have shown conflicting evidence of aspirin’s potential benefits in the general population. In patients with heart failure, some studies suggest a daily aspirin may even be harmful.
About 27 million people in the U.S. have Type 2 diabetes and about 6.5 million U.S. adults have heart failure, a condition in which the heart becomes too weak to pump enough blood to meet the body’s needs. Each condition is associated with an elevated risk of cardiac events, including heart attack and stroke. This study sheds new light on the potential risks and benefits of aspirin for people with both conditions.
Aspirin use may not provide cardiovascular benefits for patients who have peripheral vascular disease, an analysis by University of Florida Health researchers has found.
Aspirin therapy has been a staple of cardiology care for people who have peripheral vascular disease, which causes narrowed arteries and reduced blood flow to the limbs. Now, UF Health researchers’ meta-analysis of 11 aspirin therapy trials involving 6,560 peripheral vascular disease, or PVD, patients found that the drug has no significant effect on death rates and incidents of stroke, heart attack or major cardiac events. The findings were published in the journal PLOS One.
“Among patients with peripheral vascular disease, many of them may not be deriving the benefits from aspirin that they expect to be getting,” said Anthony A. Bavry, M.D., an associate professor in the UF College of Medicine department of medicine and a cardiologist at the Malcom Randall Veterans Affairs Medical Center in Gainesville.
Researchers at University of California San Diego School of Medicine and University of California, San Francisco School of Medicine report that more than 1 in 3 atrial fibrillation (AF) patients at intermediate to high risk for stroke are treated with aspirin alone, despite previous data showing this therapy to be inferior to blood thinners.
The study, which examined more than 200,000 AF patients at risk for stroke, found approximately 40 percent were treated with aspirin alone even though previous studies have demonstrated this treatment option is not as beneficial as oral blood thinners, such as warfarin, for reduction of thromboembolism, an obstruction of a blood vessel by a clot that has become dislodged.
The incidence of stroke for AF patients is up to seven times greater than in those without the condition. In AF, electrical impulses in the upper chambers of the heart are chaotic and the atrial walls quiver rather than contract normally in moving blood to the lower chambers. As a result, blood clots may form.
Cardiovascular diseases are the leading causes of death and disability in the United States, accounting for nearly one-third of all deaths. The diseases also create an immense national health economic burden.
The solution might be as simple as aspirin.
A new study published in the Journal of the American Heart Association has found that the University of Minnesota’s “Ask About Aspirin” initiative, a statewide public health campaign, is likely a beneficial and cost-effective way to reduce the incidence of a first heart attack or stroke.
The program is designed to lower cardiovascular risk in men ages 45-79 and women 55-79.
Researchers from the U of M’s School of Public Health and the Cardiovascular Division estimate that nearly 10,000 fewer heart attacks and at least 1,200 fewer strokes would occur in Minnesota as a result of improving public knowledge of aspirin use.
Aspirin is still over-prescribed for stroke prevention in atrial fibrillation (AF) despite the potential for dangerous side effects, according to research published today.
Professor Gregory Y.H. Lip, lead author of the European Society of Cardiology (ESC) study, said: “The perception that aspirin is a safe and effective drug for preventing strokes in AF needs to be dispelled. If anything, you could say that giving aspirin to patients with AF is harmful because it is minimally or not effective at stroke prevention, yet the risk of major bleeding or intracranial hemorrhage is not significantly different to well-managed oral anti-coagulation.”
He added: “All the contemporary guidelines 1 say that aspirin should not be used for the prevention of stroke in patients with AF. And yet our study shows that aspirin is still over-prescribed in these patients.”