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Warn Family & Friends: 1 in 10 Take Aspirin When They Shouldn’t

I recently wrote about how aspirin is no longer recommended as first-line therapy to prevent A-Fib stroke. (See my AF Symposium report, AHA/ACC/HRS Treatment Guideline Changes.).

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 patients take aspirin when they shouldn’t.

Warn your family and friends who are taking daily aspirin for stroke risk: Maybe they shouldn’t be.
Aspirin-rod-povray". Licensed under CC BY-SA 3.0 via Wikimedia Commons

Aspirin 3D model

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

The problem with routinely taking aspirin 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 is Aspirin Therapy 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.

Try the ACC/AHA Risk-Prediction Calculator for yourself but beware: 
Critics claim it overestimates CVD risk by 75-150% and could land you on lifelong statin therapy.

When is Aspirin Therapy Not Appropriate?

Aspirin is not appropriate for people who are at low risk—defined by their 10-year risk score. For these people, 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 FDA in 2014 released a statement that warned against widespread use (of aspirin) in people of average risk.

Like Other Blood Thinners, Aspirin is a Pharmaceutical Drug

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 is a pharmaceutical drug.

Instead of routinely taking aspirin, you should discuss aspirin therapy with our doctor just as you’d do for any ‘by prescription’ blood thinner. (Take along a copy of this post.)

Note: Suddenly stopping daily aspirin therapy could have a rebound effect that may trigger a blood clot. If you have been taking daily aspirin therapy and want to stop, 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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