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Caution: 1 in 10 Take Aspirin When They Shouldn’t (Warn your Family and Friends)

I have written about how aspirin is no longer recommended as first-line therapy to prevent A-Fib stroke. (See my Update: Aspirin No Longer Recommended as First-Line Therapy for Stroke Prevention.).

But it’s not just A-Fib patients who shouldn’t be on aspirin therapy for stroke prevention.

Data indicates more than 1 in 10 adults take aspirin when they shouldn’t.

Warn your family and friends who are taking daily aspirin: Maybe they shouldn’t be.

Aspirin, acetylsalicylic acid, is a pharmaceutical drug

50 Million in the US Take Aspirin for Prevention of Cardiovascular Disease

The problem with routinely taking aspirin, acetylsalicylic acid (ASA), is an increased risk of bleeding complications. More than one-third of all adults in the U.S. are now taking aspirin for primary and secondary prevention of cardiovascular disease (CVD).

“Primary” means preventing a first event like a heart attack. “Secondary” means preventing a reoccurrence of an event, like a second stroke.

When Aspirin Therapy Is Appropriate

As a “primary” prevention, only patients with a moderate to high 10-year risk of cardiovascular disease and stroke should be on aspirin therapy (estimated using the ACC/AHA risk-prediction calculator or similar calculator).

Aspirin is recommended for “secondary” prevention.

If you’ve had a stroke, aspirin IS appropriate as a means of preventing a re-occurrence or ‘secondary’ event.

When Aspirin Therapy Is Not Appropriate

Aspirin is not appropriate for adults who are at low risk of cardiovascular disease—defined by their 10-year stroke risk score. For these adults, the risks of gastrointestinal bleeding and hemorrhagic strokes outweigh any potential benefit.

“Among the more than 16,000 deaths each year linked to bleeding… about one-third of these deaths occur in those who take low-dose (81-mg) aspirin.” The 2014 an FDA statement warned against widespread use of aspirin in adults of average risk.

Aspirin is a Drug, Just Like Other Blood Thinners

It’s all too easy to take an aspirin―we don’t need a prescription to get it. But taking an aspirin isn’t like taking a vitamin. Aspirin, acetylsalicylic acid (ASA), is a pharmaceutical drug.

Warn Loved Ones Taking Daily Aspirin

Maybe they shouldn’t be! Instead of routinely taking aspirin, adults should discuss aspirin therapy with their doctor just as they’d do for any ‘by prescription’ blood thinner. (Hint: Take along a copy of this post.)

Caution: Suddenly stopping daily aspirin therapy could have a rebound effect that may trigger a blood clot. It’s important to talk to your doctor before making any changes.

References for this article
ACC/AHA Risk Calculator: http://www.cvriskcalculator.com/

O’Riordan, M. Another Study Shows ACC/AHA Risk Calculator Overestimates CVD Events. February 18, 2015. Heartwire from Medscape. Last accessed Aug 8, 2015. URL: http://www.medscape.com/viewarticle/839912

Hira RS et al. Frequency and practice-level variation in inappropriate aspirin use for the primary prevention of cardiovascular disease: Insights from the National Cardiovascular Disease Registry’s Practice Innovation and Clinical Excellence registry. JACC, Volume 85, Issue 2, January 2015:111-121.doi:10.1016/j.jacc.2014.10.035

Daily aspirin therapy: Understand the benefits and risks. March 21, 2015. MayoClinic.org. Last accessed Aug 12, 2015. URL: http://www.mayoclinic.org/diseases-conditions/heart-disease/in-depth/daily-aspirin-therapy/art-20046797

Stafford, Randall S., The Aspirin Question. Bottom Line/Health. Volume 29, Number 10, October 2015.

Image credit: Licensed under CC BY-SA 3.0 

 

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