Make us your home page
Instagram

Today’s top headlines delivered to you daily.

(View our Privacy Policy)

For heart attack, stroke prevention, weigh benefits of aspirin therapy against risks

You've undoubtedly heard that a baby aspirin a day will help prevent the formation of blood clots that could cause a heart attack or stroke. Well, the aspirin probably won't help you much if you've never had a heart attack or stroke, according to a study published in the March 3 issue of the Journal of the American Medical Association.

But don't throw away your baby aspirin just yet. Even though it may not be right for you today, it might help you prevent cardiovascular problems later in your life, according to Dr. Jeffrey S. Berger, who comments on the study in an editorial in the same issue of JAMA.

Basically, the potential benefit of aspirin depends on your own risk of heart disease, which you must balance against the risks and benefits of aspirin.

"Aspirin continues to have benefit — it decreases cardiovascular events by approximately 20 percent," said Berger, assistant professor of medicine at New York University's Langone Medical Center. "But if your initial risk is low, then your absolute benefit is very low."

Suppose, for example, that your risk of having a heart attack is about 2 percent per year, based on such risk factors as your blood pressure, cholesterol level and family history. If you take a baby aspirin every day and decrease your risk by 20 percent, you'll get your risk down to 1.6 percent — a trivial decrease. If your risk of having a heart attack is 10 percent, however, you'll reduce your risk by 2 points, to 8 percent.

Now the benefit of taking aspirin probably offsets the risk.

What risk?

"There can be a significant amount of bleeding with aspirin — bleeding in the GI tract and in the brain," Berger said. "That's why it's so important to understand each patient's risk factor profile.

"It's not that aspirin is more effective in one type of patient; it's that the patient with the higher risk-factor profile will obtain greater benefit. It's important to understand risk before you can determine the overall benefit."

The authors of the JAMA study screened nearly 29,000 men and women between the ages of 50 and 75 who were free of cardiovascular disease. Of those they selected, 3,350 had a low ankle brachial index; that's a measure that compares a blood pressure reading taken at the ankle with one taken at the arm. Those whose blood pressure is lower at the ankle than it is at the arm probably have some degree of peripheral artery disease — an early sign of cardiovascular disease.

Half of those 3,350 participants took 100 milligrams of aspirin a day, while the other half took a placebo.

Over the next few years, 357 participants had a heart attack or stroke, but they were evenly divided between the two groups. The aspirin appeared to provide no protection.

And among the 54 participants who experienced brain bleeding severe enough to land them in the hospital, 34 were taking aspirin while only 20 were taking a placebo.

So should you take a baby aspirin every day to reduce your chances of having a heart attack or stroke?

According to Berger, if you've had a heart attack or stroke, a baby aspirin a day — get the enteric, coated kind for less stomach upset — probably will reduce your risk of a recurrence significantly enough to offset the increased risk of internal bleeding that aspirin causes.

"I think it's important to remember that aspirin is an important disease-modifying drug in patients who have established or symptomatic cardiovascular disease," he said. "And if you take aspirin, you should take the lowest effective dose because of the risk-benefit profile. A higher dose does not confer greater benefit, but it does increase risk."

Tom Valeo writes frequently about health matters. He can be reached at tom.valeo@gmail.com.

For heart attack, stroke prevention, weigh benefits of aspirin therapy against risks 07/27/10 [Last modified: Tuesday, July 27, 2010 11:34pm]
Photo reprints | Article reprints

© 2017 Tampa Bay Times

    

Join the discussion: Click to view comments, add yours

Loading...
  1. Report: Trump asked intel chiefs to push back against FBI collusion probe after Comey revealed its existence

    National

    President Donald Trump asked two of the nation's top intelligence officials in March to help him push back against an FBI investigation into possible coordination between his campaign and the Russian government, the Washington Post reports, citing current and former officials.

    From  left, CIA Director Mike Pompeo; Director of National Intelligence Dan Coats; and National Security Agency Director Adm. Michael Rogers take their seats on Capitol Hill on May 11 before  testifying before the Senate Intelligence Committee hearing on major threats facing the U.S. [Associated Press]
  2. Trump asked intelligence chiefs to push back against FBI collusion probe after Comey revealed its existence

    National

    President Donald Trump asked two of the nation's top intelligence officials in March to help him push back against an FBI investigation into possible coordination between his campaign and the Russian government, current and former officials said, according to the Washington Post.

    After President Donald Trump fired James Comey, shown here, as FBI director, the Washington Post is reporting, Trump made separate appeals to the director of national intelligence, Daniel Coats, and to Adm. Michael S. Rogers, the director of the National Security Agency, urging them to publicly deny the existence of any evidence of collusion during the 2016 election.
  3. For Gov. Rick Scott, 'fighting' could mean vetoing entire state budget

    State Roundup

    Every day, Gov. Rick Scott is getting a lot of advice.

    The last time a Florida governor vetoed the education portion of the state budget was in 1983. Gov. Bob Graham blasted fellow Democrats for their “willing acceptance of mediocrity.”
  4. Romano: Time is up chief, make a call on police body cameras

    Crime

    Excuse me chief, but it's time to take a stand.

    St. Petersburg police Chief Tony Holloway
  5. Potential new laws further curb Floridians' right to government in the Sunshine

    State Roundup

    TALLAHASSEE — From temporarily shielding the identities of murder witnesses to permanently sealing millions of criminal and arrest records, state lawmakers did more this spring than they have in all but one of the past 22 years to chip away at Floridians' constitutional guarantees to access government records and …

    The Legislature passed 17 new exemptions to the Sunshine Law, according to a tally by the First Amendment Foundation.