Risks of daily aspirin may outweigh the benefits



Taking a low-dose aspirin every day can help prevent heart attacks in people who've already had one. But if you've never had a heart attack (or stroke), the risks of taking a daily low-dose aspirin outweigh the benefits, according to a U.K. report published in Drug and Therapeutics Bulletin.


About 50 million Americans take low-dose (325 milligrams per day or less) aspirin to prevent cardiovascular problems. Some do so even though they don't have heart disease or a history of heart attack or stroke, an approach known as primary prevention.


Currently, the American Diabetes Association (ADA) recommends low-dose aspirin for primary prevention in people with diabetes who are at risk for cardiovascular disease--but this will be changing. (Diabetes can dramatically increase the risk of developing heart disease.)


"Because of some recent studies suggesting that the benefit is not very large, and because aspirin can also have risks (intestinal bleeding or hemorrhagic stroke), the January 2010 recommendations will recommend it mostly for higher-risk people than was the case in the past, when it was recommended for people with more moderate levels of risk and above," says Dr. M. Sue Kirkman, the vice president of clinical affairs for the ADA.


The authors of the new analysis say there's not enough evidence to justify the routine use of low-dose aspirin to prevent cardiovascular disease in apparently healthy people, including those with elevated blood pressure or diabetes.


Kirkman stresses that people with diabetes who are taking aspirin--and have no history of heart attack--should talk to their doctor and see if he or she recommends continuing the therapy.


"There isn't a strong rationale to take people off it if they're doing fine," she explains.


Although aspirin thins the blood and helps prevent clots, it is not risk free, according to the U.K. review led by a panel of experts.


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