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Should I be using aspirin to prevent heart attack and stroke?

submitted by Dr. Shahzad Ahmed MD, FACC, FSCAI, RPVI, Interventional Cardiologist, Director, BMC Cardiology 

Aspirin is one of the most used medicine.

Approximately 23 million individuals take aspirin daily in United States who do not have established atherosclerotic cardiovascular disease (ASCVD).

Most of the people think aspirin is beneficial and prevents heart attack and strokes.

This might be true for some individuals but most of the individuals who were prescribed aspirin for primary prevention in the past would not need to be on aspirin based on the scientific data and literature and can cause serious adverse like gastrointestinal and intracranial bleeding.
What is the data and science behind new guidelines?

In the last few years, there are well-designed randomized control trials to assess the benefit of aspirin prophylaxis for primary prevention in patients at high risk of atherosclerotic cardiovascular disease (ASCVD).

Based on those trials, in 2019 the American College of Cardiology updated guidelines regarding aspirin use and stated the benefit of aspirin prophylaxis only in individuals 40 to 70 years of age with elevated risk of cardiovascular disease, provided their bleeding risk is low.

Recently, the United States Preventive Services Task Force (USPTF) drafted recommendations to be published in November for aspirin use and updated a previous statement from 2016.

The task force recommend use of aspirin in individuals 50-69 years of age with a greater than 10% risk of atherosclerotic cardiovascular disease after discussing with their clinician.

The task force also recommended against the use of aspirin in individuals greater older than 70 years of age and less than 40 years of age based on current evidence for primary prevention.
What should I do if I am taking aspirin?

If you have been prescribed aspirin for primary prevention, you should consult your primary care physician or a cardiologist to ask whether you should continue to take aspirin or not.

Should I take aspirin if I have coronary artery disease (plaque in heat arteries) or peripheral vascular disease or stroke?

If you have been prescribed aspirin following a heart attack, coronary artery disease, peripheral vascular disease or stroke, you should continue taking aspirin.  Stopping aspirin in this situation can put your health at serious risk

Dr. Ahmed is accepting patients at BMC Cardiology, 501 Bath Road, Bristol. For information, please call 215-785-5100.

Reference

  1. https://www.uspreventiveservicestaskforce.org/uspstf/draft-recommendation/aspirin-use-to-prevent-cardiovascular-disease-preventive-medication
  2. https://www.acc.org/latest-in-cardiology/acc-aha-guideline-on-primary-prevention-gl-prevention
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